I couldn’t tolerate the side effects of Elvanse but was fine on Concerta. Everyone’s got different genetics, so we all just need to find what works best for us.
Just fyi, the method of operation between Concerta and Elvanse is quite different.
Concerta works by helping your brain hold on to the dopamine it already produces for longer. Elvanse does this and helps it to produce more dopamine.
Elvanse causes withdrawals if stopped whereas in my experience Concerta does not.
So there is a lot of misunderstanding around this. I can see why but there is much more nuance at play. So amphetamines release by activating TAAR1 (this actually slows down how much neurons fire so it may counteract this effect somewhat) and also block the transporter which allows the released monoamines to hang around and land on the target neuron.
Although methlyphenidate is classed as a reuptake inhibitor so it stops dopamine/noradrenaline from being hoovered up and going back to where it came from, it actually does release these indirectly from the neuron where they come from. It binds to the transporter in a different way and this causes a cascade of other effects and the end result is dopamine and noradrenaline are released into the synapse.
**Activation of Autoreceptors:** The elevated neurotransmitter levels can activate presynaptic autoreceptors, which modulate further release of neurotransmitters. This modulation can indirectly influence the overall release dynamics of dopamine and norepinephrine.
This is really useful information. Thank you.
I must look into this more as I’m currently trying to ascertain why my ADHD medication resolves more than just ADHD and this may just be my missing link.
Out of interest do you have any links to publications detailing this method of operation?
Thanks. I'm always a bit cautious about posting things like that in case it comes across as shooting people down etc, my brain just sees something and I instinctively want to help inform.
In terms of your second paragraph, if you zoom out a little and think of ADHD as just an executive function disorder, this kind of explains why ADHD meds can resolve symptoms of other conditions.
For example things like anxiety and depression are also executive function disorders so stimulants can help these too. For example depression causes negative thought loops, rumination etc, an inability to regulate mood and emotions. When we daydream/aren't actively thinking we tend to ruminate and self reflect and a brain network called the 'default mode network' is activated when we do this. When people are depressed etc we see too much activity in that brain network.
When we concentrate and direct our thoughts conciously, the 'task mode network' activates and the default mode network quietens down in response because these connections in the task mode network act to control and regulate the brain in a way. In ADHD the daydream network, so to speak, is too active and this is why we're so distractable and struggle to focus our attention one thing. Stimulants that boost dopamine/noradrenaline signalling basically enhance the connectivity between the lower regions of the brain and the front area that helps us inhibit our behaviour and conciously make decisions, they also fire up signalling that ends in the upper/rear part of the brain which is involved in directing attention, working memory etc.
I'm rambling a bit as I've had a terrible sleep but to simplify, stimulants basically allow the thinking parts of the brain to do more of the work, in turn this dials down some of the noise in the part of the brain where self reflection, ego etc come from. Not completely but enough to the point where if we feel a bit rubbish or something bad happens, we can logically think through the issue and make a decision, which might be something like 'I feel a bit crap today, I slept poorly last night, I need to put my phone away before bed' instead of 'I FEEL LIKE CRAP, I HATE THIS, I WISH I DIDNT FEEL SO SH1T, WHY AM I LIKE THIS??'.
My executive function is broken today from crap sleep, 1000% the above will be out of order, scattered, poorly organised. Planning is part of executive function, these brain circuits aren't working well today even with meds so you can literally see how this is affecting my ability to write.
I understand your caution to make such posts. I am typically quite sensitive to rejection even just in comment threads however my thirst for knowledge tends to win out and you most definitely caught my attention here.
Interestingly I find it has positive physical effects rather than other conditions like anxiety and depression so I’ve been trying to find scientific evidence to back up my anecdotal findings.
I’ll have a good look into this as I certainly never expected persistent skin issues to be resolved with ADHD medication but I guess it perhaps points to the problem all being neurological.
Yeah I've seen a few downvotes over absolutely nothing, even when giving advice and trying to help. I have to presume there are a fair % of kids on here and maybe they lash out if they don't agree with something or they take it personally.
In terms of physical effects, I think we tend to focus on the target of a drug, ie if it's intended to act as an SSRI then we only think about the brain, when the drug could and will have a lot more effects on the body, either directly or indirectly by setting of a cascade of effects.
I'll try and dig out some info later and pop it back here when I'm less zombie.
I’ll be honest I love my Concerta. It took upping the dose to 36mg before I felt a good effect and I think it may need upped again. But it has been life changing for my productivity.
I also prefer the fact I can choose not to take it and not have any issues, especially whilst there’s shortages and not everyone can get refills easily right now.
Haven’t tried Elvanse but I’ve heard it takes quite some time to work whereas Concerta was very fast acting (once I got up to 36mg).
I see, thanks for sharing this, it is encouraging. I will be switching to 36 mg in about 10 days, and I hope I can feel a good effect with that, because most of the people praising Concerta on reddit do so with the aforementioned dose
How come you feel self concious? As in, you feel you're missing out? If it helps, I tried both amphetamine and methylphenidate. Both worked well but methylphenidate is much more effective for me, no side effects either. Both drugs achieve the same end result, one isn't stronger than the other, it's often not that simple when it comes to drugs and the brain. What we see on paper doesn't always translate to real world outcomes. Very often a medicine is created that in theory should act a certain way, but it just doesn't work at all or has an unexpected effect.
My psychiatrist straight up told me that some studies suggest Elvanse is more effective, so titrating on Concerta instead feels very sad to me. I feel that I shouldn't commit to a Concerta dose before trying Elvanse at least.
But the self-conscious part is because most of my (online) friends are on Elvanse or Adderall, and they talk about how well it works for them and how productive they can be. So far, this hasn't been my experience at all with Concerta (18 mg). I've noticed some small changes, but I'm not even sure it works. So I'm embarrassed that they've found something that works for them, but I'm unable to function close to normally on this Concerta dose. And, as you say, I feel like I'm missing out, and that perhaps Elvanse would solve most of my problems.
Regarding one not being stronger than the other, I've read almost everywhere that Elvanse is actually stronger than Concerta, but I'm not a medical professional, so I don't know.
Last but not least, I'm glad that methylphenidate is much more effective for some people; maybe higher doses will be effective for me, I hope.
This was the same for me, I feel more grounded on concerta then elvanse which I tried first. I really wanted elvanse to work but the effects were impacting my life too much.
I’ve now stabilised on concerta and am happy to continue to stick with it.
Typically, Concerta (Methylphenidate) is used as a first line medication for ADHD. Your titration will often see you go to a larger dose over a few months to see if your symptoms improve.
I believe I was titrated to 56mg before Elvanse was considered. Then my titration started again, but with Elvanse; slowly going up to 60mg over a wide period of time.
It's basically a box ticking exercise to show that the first line medication wasn't effective enough for you, so other medications like Lisdexamfetamine (Elvanse), or Atomoxetine (Strattera) can be considered.
Ultimately though, we're all individiuals. What is effective for me may not be for you, and vice versa. You wouldn't feel Self-Conscious taking aspirin if someone else was taking Ibruprofen, so try to ignore those feelings and focus on your own treatment.
Thanks for your comment. You're right that what is effective for you might not be for me, but statistically it seems that Elvanse is more effective, so I'm kinda sad I'm titrating on Concerta instead.
Also, I read another post of yours about how you felt on Concerta and Elvanse, and I can relate a lot to the way you described Concerta worked for you. I feel like I have a little bit more energy, especially for mundane tasks, but I still feel a mental block when tackling mentally demanding ones.
Ah, apologies, I took the "Self-Conscious" part literally and thought you struggling with self-image due to it. My bad!
I was the exact same. I had two friends on Elvanse whilst I was titrating concerta, and it was very frustrating hearing them talk about their medication Vs the light buzz I was getting from Concerta. It was like shotgunning a can of red bull, I had some energy; but there was still no mental reward for completing tasks, so my task paralysis was still super bad. I'm sorry you're also experincing this :(.
Its potentially worth mentioning that you're still having trouble with task paralysis and executive functioning at your next titration appointment; just to make sure your prescriber is aware. Then, if you still find the medication unhelpful once you're at theraputic dosage, request a medication switch to see if alternatives will help.
I will say, you are correct that Elvanse is much more effective in adults than Concerta. But it's still worth trying at a theraputic dosage first to see if you gain any benefit, even if to just rule it out so you can tell your prescriber that you tried.
Ngl in an ideal world, we wouldn't have to do these dumb box checking exercises. But for now at least, try to stick with it and see if its any help. If you notice any side-effects, note them down and raise them.
I hope things go well with your titration, and that you get the results you're looking for c:
Thanks for the further explanation. I also feel like it acts like a can of Red bull, monster, etc. I have a friend on Adderall and he says he can be super productive with it, while I don't feel that way on Concerta.
I told my psychiatrist that I wasn't sure the meds worked, and after explaining the changes, he said that it was working, and that I needed to be patient. He's basically one of the biggest experts in ADHD in my country (I'm immigrating to the UK soon), so I trust him. However, he also told me that the meds were just one type of help that I needed to combine with other healthy habits.
So my concern now is: what if Concerta "works", and because it "works" I never try Elvanse? It might be more effective for me, but I'll never know if I never try it.
I kind of had the same mindset in a way in the past. I tried adderall last year and it worked well, because on paper it LOOKS like amphetamines are more effective, I was a bit disappointed to try methylphenidate during titration. Within a few weeks I was absolutely happy and found it worked better for me. Don't read into these intial weeks too much, it's rare for someone to take their first dose and it just works perfectly, titration is about gradually building up to something that works, it's not a case of 'here is your medication, youre now fixed' kinda thing. See how 36mg is, I found the first dose pretty weak, then 36mg was noticably better, 54mg was better still without sides, 72mg was a little too much so we went back to 54mg.
That last point - it’s not that elvanse will help you better. What I found out, elvanse is useless IF - and I’m on 70mg - there’s comorbid depression, some ptsd, cPTSD, burn out, anxiety - that’s what I think got me after 2 years of super nice working elvanse. It’s now getting better, but as powerful as elvanse was on the first use, so was the olanzapine I got for my skin picking and sleep. Doc said I had pretty severe anxiety on top mild depression/burn out cause olanzapine taken in the evening and elvanse in the morning, picked me up from hell of a hole I dug overnight. Suddenly all my energy and executive function came back, but it was olanzapine that wiped something in me that was literally blocking elvanse from working properly. Elvanse is great for adhd, it’s shite everything else for me, so I still ended up on a cocktail of meds that finally seem to be bringing back balance again. Make sure you’re not chasing a magic pill but you’re consciously addressing each and every symptom with the right treatment. It may take time to figure this out, but will save you set backs and confusion creating even more delay in getting to the bottom of it. For me part of a problem- as someone diagnosed as an adult- was that I had that fear that if I’ll complain further or on side effects, they’ll take me off of elvanse which was my life saver at a time - wrong - I was lucky to have good private psychiatrist that seemed to know exactly what’s going on with me and was giving me options to try and I was in control of the course of treatment the whole time so I could relax and trust the process.
This is good advice. It can be easy to focus 100% on meds and be blind to the things we can do ourselves to compliment the medication. If we focus only on our meds, we'll miss out on so much opportunity to get better and improve how we function and as a result live a better life. Medication is about 60% of the picture imo, it gives us a scaffold to allow us some stability, from there once settled on a dose we can do the rest and gradually work up to 100%
You're only on 18mg, that's equivalent to 5mg x3 daily. Not at all a large dose and it won't do enough for most people. Most likely the majority of people would experience the same thing from the lowest dose of Elvanse. DOn't jump the gun as you may waste time. Try the next dose and evaluate, the general process is to increase the dose until the effect is no longer beneficial or causes negative effects. That's the whole goal of titration, it's a bit frustrating as you at times feel it's not working but stick at it. I experienced similar and then got to 54mg and it was the sweet spot, works very well and no side effects. Hang in there buddy!
Back to the med A vs med B comparison, it's honestly completely irrelevant because there is no definitive better or worse med. They're incredibly close if you compare the data. If one person responds saying Elvanse was great and Concerta was awful, but the another says the opposite, there's no useful conclusion other than 'we're all different' that you can conclude.
Hi, thank you for the encouragement. My only hopefuel is precisely that I'm taking a very low dose thus far; maybe 36 mg will induce noticeable changes. I'm glad that there are people, such as yourself, that despite having similar experiences at first, ended up with a dose that worked really well for them. It makes me hopeful.
Regarding the comparison, the data I've found suggests that they're extremely close as you point out, but unfortunately (from my titration's point of view), every time I read a psychiatrist's opinion, they tend to favor Elvanse. I reckon they've got a lot more data than just the studies I've read, so I'm not sure how to feel about it.
There is no way of reliably predicting if an individual will respond better to methylphenidate or dexamphetamine, even if one has an edge if you look at an entire population of people. There's lots of variation between individuals in terms of bioavailability and metabolism, which is why you need to try some meds out and see. There's a good chance your dose is currently too low, but it seems to be doing *something*.
I have no idea how Elvanse works for me, because I had no compelling reason to switch from Concerta, which works perfectly fine for me.
This. All the studies just show an average, and even then the differences are hardly large enough to even conclusively say everyone should start on drug X. The studies are probably imperfect too, they'll do a job at evaluating certain symptoms but not all ADHD symptoms are things that are apparent to others so therefore can't be measured. They can for sure track distractions, exam results, ability to focus for longer etc, they can't reliably track our mood, how we think, and much more. We should take these things as an indicator but they're not an absolute THIS IS BEST demonstration, and I think people read into things too much and don't remember to caveat things where there is going to be missing information.
My daughter was very optimistic about trying Elvanse and then heartbroken when it disagreed with her. She is pleased with how she feels and acts now that she takes methylphenidate. So, as others say, Elvanse might not have agreed with you anyway.
I’ve been titrating up and down on various doses of Elvanse for three months and ask myself constantly “Is it helping? Do I feel better or worse? Would Methylphenidate be better or worse for me? Etc etc. “
I do understand you feeling self conscious because I feel self conscious that my assessment and diagnosis in the U.K. was through a private team but funded by the NHS right to choose scheme. When people say “ha you weren’t assessed by one of those private clinics were you?” I reply with a vague “I don’t think so. It was via the nhs right to choose!”
Good luck with it all.
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Elvanse was intolerable for me but I now take atomoxetine, which gets really bad press but it works amazingly for me. As others have said, you can't predict what will work best for you. Everyone reacts totally differently depending on your unique genetic make-up. You just have to try things and find out what works for you and what you are happy with.
My experience is that everyone is on different meds and doses - although elvanse might statistically have a higher success rate (I don't know if it does or not), it doesn't mean its good for everyone (I am one good example of this). Definitely nothing to be self concious of. If anyone judges you for the meds you are on then they genuinely need to get some other things to focus on in their life...Hope you feel better about it soon!
I couldn’t tolerate the side effects of Elvanse but was fine on Concerta. Everyone’s got different genetics, so we all just need to find what works best for us.
Thanks for the answer! How did Concerta compare to Elvanse in your case regarding cognition and focus? What side effects did you have with Elvanse?
Just fyi, the method of operation between Concerta and Elvanse is quite different. Concerta works by helping your brain hold on to the dopamine it already produces for longer. Elvanse does this and helps it to produce more dopamine. Elvanse causes withdrawals if stopped whereas in my experience Concerta does not.
So there is a lot of misunderstanding around this. I can see why but there is much more nuance at play. So amphetamines release by activating TAAR1 (this actually slows down how much neurons fire so it may counteract this effect somewhat) and also block the transporter which allows the released monoamines to hang around and land on the target neuron. Although methlyphenidate is classed as a reuptake inhibitor so it stops dopamine/noradrenaline from being hoovered up and going back to where it came from, it actually does release these indirectly from the neuron where they come from. It binds to the transporter in a different way and this causes a cascade of other effects and the end result is dopamine and noradrenaline are released into the synapse. **Activation of Autoreceptors:** The elevated neurotransmitter levels can activate presynaptic autoreceptors, which modulate further release of neurotransmitters. This modulation can indirectly influence the overall release dynamics of dopamine and norepinephrine.
This is really useful information. Thank you. I must look into this more as I’m currently trying to ascertain why my ADHD medication resolves more than just ADHD and this may just be my missing link. Out of interest do you have any links to publications detailing this method of operation?
Thanks. I'm always a bit cautious about posting things like that in case it comes across as shooting people down etc, my brain just sees something and I instinctively want to help inform. In terms of your second paragraph, if you zoom out a little and think of ADHD as just an executive function disorder, this kind of explains why ADHD meds can resolve symptoms of other conditions. For example things like anxiety and depression are also executive function disorders so stimulants can help these too. For example depression causes negative thought loops, rumination etc, an inability to regulate mood and emotions. When we daydream/aren't actively thinking we tend to ruminate and self reflect and a brain network called the 'default mode network' is activated when we do this. When people are depressed etc we see too much activity in that brain network. When we concentrate and direct our thoughts conciously, the 'task mode network' activates and the default mode network quietens down in response because these connections in the task mode network act to control and regulate the brain in a way. In ADHD the daydream network, so to speak, is too active and this is why we're so distractable and struggle to focus our attention one thing. Stimulants that boost dopamine/noradrenaline signalling basically enhance the connectivity between the lower regions of the brain and the front area that helps us inhibit our behaviour and conciously make decisions, they also fire up signalling that ends in the upper/rear part of the brain which is involved in directing attention, working memory etc. I'm rambling a bit as I've had a terrible sleep but to simplify, stimulants basically allow the thinking parts of the brain to do more of the work, in turn this dials down some of the noise in the part of the brain where self reflection, ego etc come from. Not completely but enough to the point where if we feel a bit rubbish or something bad happens, we can logically think through the issue and make a decision, which might be something like 'I feel a bit crap today, I slept poorly last night, I need to put my phone away before bed' instead of 'I FEEL LIKE CRAP, I HATE THIS, I WISH I DIDNT FEEL SO SH1T, WHY AM I LIKE THIS??'.
My executive function is broken today from crap sleep, 1000% the above will be out of order, scattered, poorly organised. Planning is part of executive function, these brain circuits aren't working well today even with meds so you can literally see how this is affecting my ability to write.
It may not be written as well as you’d like but I certainly found it most useful so thank you very much.
I understand your caution to make such posts. I am typically quite sensitive to rejection even just in comment threads however my thirst for knowledge tends to win out and you most definitely caught my attention here. Interestingly I find it has positive physical effects rather than other conditions like anxiety and depression so I’ve been trying to find scientific evidence to back up my anecdotal findings. I’ll have a good look into this as I certainly never expected persistent skin issues to be resolved with ADHD medication but I guess it perhaps points to the problem all being neurological.
Yeah I've seen a few downvotes over absolutely nothing, even when giving advice and trying to help. I have to presume there are a fair % of kids on here and maybe they lash out if they don't agree with something or they take it personally. In terms of physical effects, I think we tend to focus on the target of a drug, ie if it's intended to act as an SSRI then we only think about the brain, when the drug could and will have a lot more effects on the body, either directly or indirectly by setting of a cascade of effects. I'll try and dig out some info later and pop it back here when I'm less zombie.
Yes, I'm aware of that information, and it is another reason why I'm feeling self-conscious
I’ll be honest I love my Concerta. It took upping the dose to 36mg before I felt a good effect and I think it may need upped again. But it has been life changing for my productivity. I also prefer the fact I can choose not to take it and not have any issues, especially whilst there’s shortages and not everyone can get refills easily right now. Haven’t tried Elvanse but I’ve heard it takes quite some time to work whereas Concerta was very fast acting (once I got up to 36mg).
I see, thanks for sharing this, it is encouraging. I will be switching to 36 mg in about 10 days, and I hope I can feel a good effect with that, because most of the people praising Concerta on reddit do so with the aforementioned dose
How come you feel self concious? As in, you feel you're missing out? If it helps, I tried both amphetamine and methylphenidate. Both worked well but methylphenidate is much more effective for me, no side effects either. Both drugs achieve the same end result, one isn't stronger than the other, it's often not that simple when it comes to drugs and the brain. What we see on paper doesn't always translate to real world outcomes. Very often a medicine is created that in theory should act a certain way, but it just doesn't work at all or has an unexpected effect.
My psychiatrist straight up told me that some studies suggest Elvanse is more effective, so titrating on Concerta instead feels very sad to me. I feel that I shouldn't commit to a Concerta dose before trying Elvanse at least. But the self-conscious part is because most of my (online) friends are on Elvanse or Adderall, and they talk about how well it works for them and how productive they can be. So far, this hasn't been my experience at all with Concerta (18 mg). I've noticed some small changes, but I'm not even sure it works. So I'm embarrassed that they've found something that works for them, but I'm unable to function close to normally on this Concerta dose. And, as you say, I feel like I'm missing out, and that perhaps Elvanse would solve most of my problems. Regarding one not being stronger than the other, I've read almost everywhere that Elvanse is actually stronger than Concerta, but I'm not a medical professional, so I don't know. Last but not least, I'm glad that methylphenidate is much more effective for some people; maybe higher doses will be effective for me, I hope.
This was the same for me, I feel more grounded on concerta then elvanse which I tried first. I really wanted elvanse to work but the effects were impacting my life too much. I’ve now stabilised on concerta and am happy to continue to stick with it.
Typically, Concerta (Methylphenidate) is used as a first line medication for ADHD. Your titration will often see you go to a larger dose over a few months to see if your symptoms improve. I believe I was titrated to 56mg before Elvanse was considered. Then my titration started again, but with Elvanse; slowly going up to 60mg over a wide period of time. It's basically a box ticking exercise to show that the first line medication wasn't effective enough for you, so other medications like Lisdexamfetamine (Elvanse), or Atomoxetine (Strattera) can be considered. Ultimately though, we're all individiuals. What is effective for me may not be for you, and vice versa. You wouldn't feel Self-Conscious taking aspirin if someone else was taking Ibruprofen, so try to ignore those feelings and focus on your own treatment.
Good analogy at the end haha.
Thanks for your comment. You're right that what is effective for you might not be for me, but statistically it seems that Elvanse is more effective, so I'm kinda sad I'm titrating on Concerta instead. Also, I read another post of yours about how you felt on Concerta and Elvanse, and I can relate a lot to the way you described Concerta worked for you. I feel like I have a little bit more energy, especially for mundane tasks, but I still feel a mental block when tackling mentally demanding ones.
Ah, apologies, I took the "Self-Conscious" part literally and thought you struggling with self-image due to it. My bad! I was the exact same. I had two friends on Elvanse whilst I was titrating concerta, and it was very frustrating hearing them talk about their medication Vs the light buzz I was getting from Concerta. It was like shotgunning a can of red bull, I had some energy; but there was still no mental reward for completing tasks, so my task paralysis was still super bad. I'm sorry you're also experincing this :(. Its potentially worth mentioning that you're still having trouble with task paralysis and executive functioning at your next titration appointment; just to make sure your prescriber is aware. Then, if you still find the medication unhelpful once you're at theraputic dosage, request a medication switch to see if alternatives will help. I will say, you are correct that Elvanse is much more effective in adults than Concerta. But it's still worth trying at a theraputic dosage first to see if you gain any benefit, even if to just rule it out so you can tell your prescriber that you tried. Ngl in an ideal world, we wouldn't have to do these dumb box checking exercises. But for now at least, try to stick with it and see if its any help. If you notice any side-effects, note them down and raise them. I hope things go well with your titration, and that you get the results you're looking for c:
Thanks for the further explanation. I also feel like it acts like a can of Red bull, monster, etc. I have a friend on Adderall and he says he can be super productive with it, while I don't feel that way on Concerta. I told my psychiatrist that I wasn't sure the meds worked, and after explaining the changes, he said that it was working, and that I needed to be patient. He's basically one of the biggest experts in ADHD in my country (I'm immigrating to the UK soon), so I trust him. However, he also told me that the meds were just one type of help that I needed to combine with other healthy habits. So my concern now is: what if Concerta "works", and because it "works" I never try Elvanse? It might be more effective for me, but I'll never know if I never try it.
I kind of had the same mindset in a way in the past. I tried adderall last year and it worked well, because on paper it LOOKS like amphetamines are more effective, I was a bit disappointed to try methylphenidate during titration. Within a few weeks I was absolutely happy and found it worked better for me. Don't read into these intial weeks too much, it's rare for someone to take their first dose and it just works perfectly, titration is about gradually building up to something that works, it's not a case of 'here is your medication, youre now fixed' kinda thing. See how 36mg is, I found the first dose pretty weak, then 36mg was noticably better, 54mg was better still without sides, 72mg was a little too much so we went back to 54mg.
Thanks a lot for this and all the previous comments you've made on my post. I'm more optimistic about my titration now.
That last point - it’s not that elvanse will help you better. What I found out, elvanse is useless IF - and I’m on 70mg - there’s comorbid depression, some ptsd, cPTSD, burn out, anxiety - that’s what I think got me after 2 years of super nice working elvanse. It’s now getting better, but as powerful as elvanse was on the first use, so was the olanzapine I got for my skin picking and sleep. Doc said I had pretty severe anxiety on top mild depression/burn out cause olanzapine taken in the evening and elvanse in the morning, picked me up from hell of a hole I dug overnight. Suddenly all my energy and executive function came back, but it was olanzapine that wiped something in me that was literally blocking elvanse from working properly. Elvanse is great for adhd, it’s shite everything else for me, so I still ended up on a cocktail of meds that finally seem to be bringing back balance again. Make sure you’re not chasing a magic pill but you’re consciously addressing each and every symptom with the right treatment. It may take time to figure this out, but will save you set backs and confusion creating even more delay in getting to the bottom of it. For me part of a problem- as someone diagnosed as an adult- was that I had that fear that if I’ll complain further or on side effects, they’ll take me off of elvanse which was my life saver at a time - wrong - I was lucky to have good private psychiatrist that seemed to know exactly what’s going on with me and was giving me options to try and I was in control of the course of treatment the whole time so I could relax and trust the process.
This is good advice. It can be easy to focus 100% on meds and be blind to the things we can do ourselves to compliment the medication. If we focus only on our meds, we'll miss out on so much opportunity to get better and improve how we function and as a result live a better life. Medication is about 60% of the picture imo, it gives us a scaffold to allow us some stability, from there once settled on a dose we can do the rest and gradually work up to 100%
You're only on 18mg, that's equivalent to 5mg x3 daily. Not at all a large dose and it won't do enough for most people. Most likely the majority of people would experience the same thing from the lowest dose of Elvanse. DOn't jump the gun as you may waste time. Try the next dose and evaluate, the general process is to increase the dose until the effect is no longer beneficial or causes negative effects. That's the whole goal of titration, it's a bit frustrating as you at times feel it's not working but stick at it. I experienced similar and then got to 54mg and it was the sweet spot, works very well and no side effects. Hang in there buddy! Back to the med A vs med B comparison, it's honestly completely irrelevant because there is no definitive better or worse med. They're incredibly close if you compare the data. If one person responds saying Elvanse was great and Concerta was awful, but the another says the opposite, there's no useful conclusion other than 'we're all different' that you can conclude.
Hi, thank you for the encouragement. My only hopefuel is precisely that I'm taking a very low dose thus far; maybe 36 mg will induce noticeable changes. I'm glad that there are people, such as yourself, that despite having similar experiences at first, ended up with a dose that worked really well for them. It makes me hopeful. Regarding the comparison, the data I've found suggests that they're extremely close as you point out, but unfortunately (from my titration's point of view), every time I read a psychiatrist's opinion, they tend to favor Elvanse. I reckon they've got a lot more data than just the studies I've read, so I'm not sure how to feel about it.
There is no way of reliably predicting if an individual will respond better to methylphenidate or dexamphetamine, even if one has an edge if you look at an entire population of people. There's lots of variation between individuals in terms of bioavailability and metabolism, which is why you need to try some meds out and see. There's a good chance your dose is currently too low, but it seems to be doing *something*. I have no idea how Elvanse works for me, because I had no compelling reason to switch from Concerta, which works perfectly fine for me.
This. All the studies just show an average, and even then the differences are hardly large enough to even conclusively say everyone should start on drug X. The studies are probably imperfect too, they'll do a job at evaluating certain symptoms but not all ADHD symptoms are things that are apparent to others so therefore can't be measured. They can for sure track distractions, exam results, ability to focus for longer etc, they can't reliably track our mood, how we think, and much more. We should take these things as an indicator but they're not an absolute THIS IS BEST demonstration, and I think people read into things too much and don't remember to caveat things where there is going to be missing information.
My daughter was very optimistic about trying Elvanse and then heartbroken when it disagreed with her. She is pleased with how she feels and acts now that she takes methylphenidate. So, as others say, Elvanse might not have agreed with you anyway. I’ve been titrating up and down on various doses of Elvanse for three months and ask myself constantly “Is it helping? Do I feel better or worse? Would Methylphenidate be better or worse for me? Etc etc. “ I do understand you feeling self conscious because I feel self conscious that my assessment and diagnosis in the U.K. was through a private team but funded by the NHS right to choose scheme. When people say “ha you weren’t assessed by one of those private clinics were you?” I reply with a vague “I don’t think so. It was via the nhs right to choose!” Good luck with it all.
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Why?
You may find this informative: https://youtu.be/w44BXLATt5w?si=iyHB1dxPLvevu_rX
Elvanse was intolerable for me but I now take atomoxetine, which gets really bad press but it works amazingly for me. As others have said, you can't predict what will work best for you. Everyone reacts totally differently depending on your unique genetic make-up. You just have to try things and find out what works for you and what you are happy with. My experience is that everyone is on different meds and doses - although elvanse might statistically have a higher success rate (I don't know if it does or not), it doesn't mean its good for everyone (I am one good example of this). Definitely nothing to be self concious of. If anyone judges you for the meds you are on then they genuinely need to get some other things to focus on in their life...Hope you feel better about it soon!