Stimulants Switching to Concerta after decade of Adderall, questions about Vyvanse

[gentian]

Note: My previous medical provider shuttered down very suddenly at the beginning of December '16. I was consequently demedicated for an interim period of about four months before being able to see my current doctor, so overt tolerance isn't so much a concern (although I'm sure it has something to do with any decreased effectiveness due to methylphenidate+amphetamine crosstolerances).

I was diagnosed inattentive-type ADD at age 12 and prescribed Adderall, and was diagnosed with aspergers and shift work disorder at age 18 in college. I have no hyperactivity but do struggle intensely with fatigue--I have a long-standing diagnosis of Chronic Fatigue syndrome going back to 18 as well.
I've been on Adderall consistently for over a decade now and over that period of time have had to step up my dosage to where I was taking about 45mg a day, compounding IR+XR's. I know comparatively this isn't a lot, but it is an abnormally high daily amount for a low-weight, non-abusing female, and I've been reaching the point over the past year or so where the mania and adderall crashes were outweighing more of the ability and focus than the drug provided me. The crashes and nausea have become particularly bad the older I've gotten––suicidal ideations, fetal position anxiety, dry heaving, etc etc
One of the reasons I stuck with adderall so consistently throughout the years was because it provided energy/motivation to offset my CFS (and because provigil is NEVER prescribed to women my age), but the side effects and cons have begun to radically outweigh the pros. So, I saw an opportunity to try a new medication with the shuffle in my medical provider. He prescribed me on 18mg stacking Concerta and scheduled me in about two weeks, saying to experiment with the dosage on my own since I do have a long history of well-managed medications.

Second day in, noted side effects:
-digestion disturbances (hell of a lot of gas)
-the dull "caffeine buzz" of shitty coffee
-it wakes me up but there's still a lot of fog and exhaustion
-EXTREMELY inattentive, the distracting "caffeine buzz" actually makes my ADD worse. The nature of my work is a lot of short-deadline overnight writing. this is not a good combination.

I'm doing a lot of reading and it seems Concerta is very 50/50 for those switching from Adderall. I'll wait and see for now but I don't have high hopes; my doctor had also mentioned Vyvanse as a possible adderall alternative because it's also an amphetamine, and the only reason I didn't was because I've heard AWFUL accounts of Vyvanse nausea. My aspergers already makes me very gastrointestinally sensitive and I barely tolerated the last few years of addy illness--does anyone have any experience with this, especially those that are exclusively inattentive type ADD?

 

[Slow_Mobius]

An extended release version of dexedrine may suit you well if your prescriber will give it to you. Otherwise, I think Vyvanse would be a better fit for your situation than concerta. Sounds like the concerta isn't working for you, and the Vyvanse will be kind of like an extended release, less abusable version if Adderall, although I have no personal experience using it. Good luck

 

[Nib]

I absolutely love Vvyanse. I was Prescribed Adderall mainly for MDD @90mg a day. (30ir x 3). I switched to Vvyanse 70mg x 2 and it was exactly what I needed. It lasted the whole day and it was smooth as butter. Gentle up and gentle down. No tweaky cracked out feeling like the Adderall. I just couldn't stay on it because insurance wouldn't cover it and it was $400 a month.

 

[gentian]

Thanks for your experience and advice. The past couple days have been hellacious and I'm going to stop Concerta immediately following an (unsurprising) bloody stool this morning. Hoping to get in a phone call to my doctor this afternoon, will DEFINITELY ask him about making the switch. He was open to Vyvanse and so far as I know its still on the table (I'm praying it is, lol). A quick consult of my insurance coverage tells me it would be covered at $47/mo.
Super surprised that Vyvanse gets the "morning sickness" rap when Concerta is SO bad with the nausea/headsickness/dehydration! I wonder if it's because so few adults comparatively are on it solely, instead of accompanied by other medications.

For fun, recapping the past few days–
-Four days ago the crippling nausea started. way worse than the nausea/head pain I experienced during amphetamine WD's. I've puked twice over the past 72hrs and it's impossible to keep in food (unless I eat at 2/3am, which is bad) because everything is passing through me.
-Bloody stool.
-I've learned to take it with food in the early morning, however this seems to inadvertently worsen the nausea when it kicks in because then I'm puking up a whole meal versus manageable seasickness on an empty stomach.
-Extremely dehydrated, 24/7, and drinking water only seems to make this worse, because whatever water I drink runs straight through me if I don't puke it up first. It's almost like alchemy, except instead of turning water into wine or pebbles to gold, Concerta turns a quart of water into disproportionate rivers of piss.
-Visual 'aura' hallucinations, pinpricks on 36mg/day starting day 6. This is probably a combination of extreme dehydration and sudden onset malnutrition for an otherwise healthy person. In my right mind I would probably find these fun or even charming, but the prominent existential dread sideeffect (notably, not listed on the bottle––worth a suit, imo) puts a bit of a damper on that
-I stopped working out about a week ago because the loose stool/diarrhea is exacerbated with exercise. Unliveably so. There's nothing quite as uncomfortable as a female weightlifter as getting the sudden-onset "gotta shit sweats" during a squat lift because you deigned to have a protein bar mid-workout.
-Bloody stool.
-Brain fog! Again probably the intense dehydration and inability to eat, but still. Not fun.
-In this very short span of daily usage, my scent chemistry has totally changed (way worse than I initially anticipated). I'm used to managing stimulant BO and have for years with no issues, but have met my match in Concerta's faint perfume of combustable rubbers interplaying with the heady undercurrent of rotten eggs.

I've never had a medication make me feel so...for lack of better words, filthy and nigh masochistic. I was expecting some potential compatibility problems after being on tweaker-esque amphetamines for so long, but Concerta really takes the cake.