Vyvanse and Adderall... tolerance or abuse??

[partyoffive]

Hi, I'm new here and this is my first post. I joined this site hoping to gain insight into my prescription drug use. So here goes...I have been taking vyvanse and adderall in varying doses for several years. I recently took about a year off from my medicines while I was pregnant. Baby is 18 months old now and I have been back on my medicines for about a year now. Currently I am prescribed 50 mg Vyvanse once daily and 20 mg Adderall once daily. I have been at this dosage for maybe 6-8 months and for the last couple of months, the medicine seems to wear off much more quickly and I end up taking more than my daily prescribed dose, then running out early every month. I have been very hesitant to discuss this with my MD because I have gotten the vibe from him, on more than one occasion, that he was either (a) suspicious that I was abusing the medicine, or (b) maybe suspicious that I could be selling them. At one visit, he stated that the FDA was beginning to enforce strict guidelines with prescribing these meds, and that since I hadn't taken this medication as an adolescent, and only as an adult, eventually he would have to quit prescribing them to me (!) Honestly, I don't know if I meet criteria for ADD or not, but I do know that now, after having been taking these medicines for all this time, that when I run out, I am definitely struggling! So I guess my question is this...does the fact that the medicines are no longer working as they once were, prove that I not truly ADD and, instead, just abusing this medicine? Or am I normal to have these issues?
Also, I have found that part of the reason I find myself taking more than the prescribed dose, is because my mood is 100% better when I am taking the medications. When I run out and do not have them, I am stressed out and uptight and tense.
Thank you for insight you may can offer

 

[Grand Touring]

First off, you're definitely on a much higher than therapeutic dose. And I can tell this because: you're on two different amphetamines, you are running out of meds early, which shows you're getting addicted to it, even if it's just a buzz. Tolerance is a natural thing and I get it with my Adderall. But what's been said on this site countless times is that 'less is more'. If you were to take time off/lower your dose, you will get a therapeutic response, which for people who really have an attention disorder, is a calming effect from their medication. This happens by stimulating your frontal lobes, limiting impulse and inhibition. So ask yourself if these things are happening.

 

[missmeyet?]

No dear, you are not on a "much higher than therapeutic dose" (unless you are running out in like a week). I have known of people who are prescribed a much higer dose than you are on.

Secondly, out of all the drugs I have ever taken, both prescribed and illicit, nothing builds up a tolerance faster than prescription amphetamines. It has been discussed on here before and I know that many people agree. This is why people frequently give them a break on weekends and whenever possible. Pick a few days a week (or a week or 2 at a time) that you don't have so much to do and take a break. It will help with tolerance. As far as abuse goes, a doctor considers anything other than the directions for the script to be abuse. Technically the term abuse applies to when you can't function without the drug and it is controlling and interferring with your life (short version of the definition).

Yes, the DEA and others are coming down hard on doctors regarding all scheduled drugs now. A doc (to cover his own ass) usually needs to show (in the documentation/charts) why a patient is on this drug (a legit reason), other things/treatments that have been tried, effective results from the drugs, how the drugs are helping with quality of life/functioning, etc. Many doctors are getting nervous, telling their patients they can no longer prescribe (opiates, stims, etc) because it is easier to just stop prescibing them than worry about the DEA.

My advice would be not to ask for an increase as it. Sounds like your doc is considering stopping anyways and this would most likely push it over the edge. Just give yourself some breaks periodically (no matter how inconvienient it is).

TLDR- I don't know the extent to which you are "overusing" your meds but without periodic breaks from prescription amphetamines you will quickly build up a tolerance. I wouldn't push and ask for more. Abuse by docs is considered anything other than prescribed dose, technically abuse is when you are dependent on a drug to function and it is interferring with your life.

 

[Bob Loblaw]

Tolerance & dependency IMO.


~~> Basic

 

[Alex000]

In short, after having taken amphetamines, like Vyvanse and Adderall, chronically (everyday) for a decent amount of time, tolerance will develop to a good deal of the amphetamines' effects. It is so with everyone to an extent, in time. It is just how amphetamines work. It does not mean, in and of itself, that you do not have ADHD, for you very well could; or, you could not - I do not know, because something like this will not tell of a positive or negative diagnosis. ADHD is a disorder with which amphetamines, and like stimulants, are frequently prescribed for therapeutic purposes, however it is not just 'ADHD medicine'; amphetamines' effects prove quite effective, a good deal of the time, with a case of ADHD, in the short-term, with a less favorable set of effects in the longer term, but that is why they are used for ADHD - they, among other things, allow for better focusing of one's concentration on a single task, feeling of reward for working to complete a task and having completed it, and allow one to think more quickly and more efficiently. Amphetamines have been, historically, used for many other symptoms and syndromes/disorders, and sometimes still are. I am prescribed Adderall XR, mainly because of my chronic fatigue syndrome and fibromyalgia; for me, it is one of those cases where it is not prescribed for ADHD.

In any event, I cannot tell you whether or not you ought to continue taking amphetamines; there are potential up's and potential down's. I cannot say if you ought to have your dose increased, or medication slightly modified in form; it is possible. I can tell you that if you come off amphetamines, those effects of discontinuation (e.g. irritability) will lessen and lessen in time - it doesn't remain like that. But, that is just a piece of information not specific to your case about which I know next to nothing, really, and so cannot give out much medical recommendation, let alone advice.

 

[partyoffive]

Thank you for your feedback. I typically run out about 5-7 days before I'm up for a refill. That med vacation does typically help with my built up tolerance for a while. I am not typically mean or anything when I'm out of my meds, I just sleep a ridiculous amount and have a very hard time seeing any task through to completion and my work suffers greatly. My job requires that I be able to do multiple tasks at once and remember a lot of information that is constantly changing, for 12 hours at a time. That's really where I see my biggest struggle to be.

 

[partyoffive]

At this point I am considering talking to my doctor about adding some sort of antidepressant. I figure this may help to lift my mood, instead of looking to vyvanse or adderall to help with that, because I feel like when my mood is lifted, I have more interest in taking part in life around me...because when I'm out and not taking the medication, it is near impossible for me to complete any task. And yes, when I am on the medication, I definitely feel a "calming" effect. I am more confident, my mood is lifted, and I feel capable of accomplishing the tasks before me without feeling so overwhelmed by them that I just want to check out

 

[april11]

At this point I am considering talking to my doctor about adding some sort of antidepressant. I figure this may help to lift my mood, instead of looking to vyvanse or adderall to help with that, because I feel like when my mood is lifted, I have more interest in taking part in life around me...because when I'm out and not taking the medication, it is near impossible for me to complete any task. And yes, when I am on the medication, I definitely feel a "calming" effect. I am more confident, my mood is lifted, and I feel capable of accomplishing the tasks before me without feeling so overwhelmed by them that I just want to check out

Have you thought about maybe stopping the Vyvanse and upping your dose of adderall? 20 mg is not a big dose. I would also ask his opinion on an antidepressant. I got very depressed when I took adderall. Good luck.

 

[partyoffive]

I visited my doctor this week and have started back on Prozac. I took it for 6 or 7 years but have been off of it for about 5 years now. It worked well when I was taking it so I figure I will try it again so far I've only been taking it a few days so can't tell yet about the effects. I am hopeful though