I got diagnosed with combined type earlier this year and have been in titration for 8 weeks and would really appreciate any advice/support!
Context:
I was first prescribed Elvanse - starting at 20mg going up weekly to 40mg which I stayed on for two weeks.
Experience: The first day of taking 20mg I was so productive! I did so much, but then after that I couldn’t feel any impact at all on my ability to focus or be productive, even when increasing dose.
Good side effects:
- My brain was SO quiet
- It helped me to sleep much better!
Bad side effects:
- Rebound fatigue in the morning was intense
- Upset tummy/less appetite
- No noticeable improvement in my focus or executive functioning
- For some reason it made my knee joints hurt ALOT(?)
After taking it at 8am would get a significant drop in mood about 1pm and get quite depressive thoughts for around two hours.
Considering it had no positive impact on my focus/productivity after the first dose, apart from quietening my brain and enabling me to get better sleep, which I really appreciated, I can see why they decided to take me off it.
I was told to start Medikinet XL 4 days after stopping Elvanse so I am now on that - I started at 10mg, am now on 20mg and will be increasing by 10mg a week up until 40mg.
Good side effects:
- Improved productivity
- Calm later in the day
Bad side effects:
- Suffering with a little insomnia
- Upset tummy
- Morning anxiety
After taking it in the morning with a high protein breakfast I feel a high increase in anxiety! It starts about an hour after so I assume it’s kicking in at that point (like I’m in fight/flight/freeze mode) like something terrible is going to happen, but only for 3/4 hours or so, then I’m (kind of) productive and can focus (I don’t feel particularly anxious outside this period and I feel like my anxiety is reasonably under control atm).
(I will say my morning routine is terrible and is something I am working on! I work from home and after I take it I stay bed a while working from there though I am trying to work on this as I hate myself later in the day for it. I am aware that the increase in anxiety could be a result of my body being stimulated but having nowhere to put that energy due to my morning routine. It’s baby steps at the moment but my ideal situation would be to manage to get up in the morning and stay up, then build on that. I’m waiting for a psycho education spot to become available which will hopefully be helpful too)
So I come to the part where I am curious of peoples’ experiences and any advice that might be helpful!
Regarding the Elvanse -
It seems like such a short period to test a medication out and let my body adapt - I know side effects can ease after a while so…
Would this period of 5 weeks be considered normal?
Would it have been enough time to see if my body adjusted and see if things would have picked up?
Regarding the Medikinet XL -
Is it usual to have increased anxiety when first starting on it? I assume it is possible this could subside(or get worse) but that will only be apparent with time. I have considered a different release like Concerta but I think it could be too early to tell!
Is there anything that helps people lessen this, like morning exercise, being productive etc (basically something so the energy is used up)?
(I don’t expect these pills to be a magical “fix”… I see them more as something that slightly assists me in getting to a certain level functioning after bettering my routine & habits)
Regarding routine -
When taking medication are there certain things in your routine, particularly in the morning, that are a must?
I know everyone is different but any advice is SO appreciated! I’m willing to try anything to help myself!