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Lisdexamfetamine (Vyvanse)

Discussion in 'Adderall' started by moda00, Jan 14, 2008.

  1. moda00

    moda00 R.I.P. Platinum Member & Advisor

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    A friend of mine was recently switched from his methylphenidate prescription to "Vyvanse," which is lisdexamfetamine. He gets 30mg orange and white caps, to be increased as needed over the next few weeks. He is a bit of a crackhead, so take this with a grain of salt, but told me he did some "research" on them online, and that they "affect the same receptors as coke/crack" and that they are "a better smoother high to snort than Adderall (mixed amphetamine salts) or Methylphenidate (aka Ritalin)." Now, I did some research of my own, and it seems to be a very recently released and approved drug, so not much info in the way of recreational use or experience reports. But pharmaceutically, I found out that this is a mixture of d-amphetamine with l-lysine. It's considered a "prodrug" with less abuse potential than traditional add/adhd drugs, and states that since the l-lysine is removed and the amps are absorbed directly in the gastrointestinal tract. It also states it is approved for children age 6-12, but my friend is in his late 20's.. likely off-label Rx'ing. Now, I'll copy and paste what I found below, but was wondering if those with any knowledge of this drug, or of chemistry in general, could give some input.

    Anyways, my friend, I'll call her swim, was given some of these pills. She doesn't like high doses of uppers, usually uses orally to help with attention/wakefulness due to hypersomnia associated with a medical condition. She asked me to seek some info on here and advise her to understand more about these pills. Would these pills NOT be active nasally due to the l-lysine formulation or whatever, was her crackhead friend simply getting placebo? What does the "prodrug" designation mean, if the l-lysine molecule is removed with normal use as prescribed? In case anyone is wondering, it is in a capsule, but instead of beads like Adderall, it looks like fine white powder. Would a 30-mg pill have 30mg amphetamines, or 30mg of this combination of amps/l-lysine? Since Adderall is mixed amp salts, and methylphenidate (is it even technically an amphetamine??), how would dosage stack up. Would it be comparable to Dexedrine, which is just dextroamphetamine, in my understanding?? Another site/study I found says something about 25mg lisdexamfetamine being comparable to 10mg dexedrine/dextroamphetamine... and another said a study of euphoric effects placed 150mp lisdexamphetamine with 40mg adderall. But then some of the articles make it sound like the dosages between this new drug and Adderall etc. are the same or in very similar ranges.. And what is the time-release status comparable to similar substances? Anyone with any input- all advice appreciated. Some info copy/pasted below.


    Lisdexamfetamine Dimesylate (Vyvanse™)
    Date: May 22, 2007
    Manufacturer: Shire US Inc.
    Lisdexamfetamine dimesylate was FDA approved on February 23, 2007 for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD; DSM-IV®) in children 6 to 12 years old. Lisdexamfetamine is an inactive prodrug that is converted to dextroamphetamine after absorption through the gastrointestinal tract. Dextroamphetamine blocks the re-uptake of both dopamine and norephinephrine into the presynaptic neuron, thereby increasing their release into the synaptic cleft. However, the precise mechanism for improving ADHD symptoms is unknown. The parent drug, lisdexamfetamine, does not bind reuptake sites in vitro, which may decrease its potential abuse liability.
    Lisdexamfetamine is rapidly absorbed from the gastrointestinal tract. L-lysine is cleaved from the parent compound by first-pass intestinal or hepatic metabolism, releasing dextroamphetamine. The time to reach maximum plasma concentrations of dextroamphetamine is 3.5 hours, but can be delayed an additional hour if taken with food. Lisdexamfetamine is not metabolized by cytochrome P450 enzymes. No drug interaction studies are available for dextroamphetamine, although it is a minor inhibitor of CYP2D6, CYP1A2, and CYP3A4. It is 96% renally excreted with an average plasma half life of 10 -13 hours.
    Two unpublished randomized, double-blind, placebo-controlled trials in children 6-12 years old assessed the efficacy of lisdexamfetamine. In the first trial, patients were randomized to receive either placebo or fixed doses (30, 50, or 70 mg) of lisdexamfetamine once daily for 4 weeks. Statistically significant improvements in patient behavior (ADHD Rating Scale) were seen and maintained throughout the day with all doses compared to placebo.
    The second trial used a cross-over design where patients were first titrated to stable doses of Adderall XR®. Next, patients received lisdexamfetamine (30, 50, or 70mg), placebo, or continued their same dose of Adderall XR®. Each treatment was taken once daily for 1 week. Patients taking lisdexamfetamine or Adderall XR® showed significant improvements in patient behavior (SKAMP-Deportment Rating Scale) vs. placebo. There was no significant difference in improvement between the active treatments.
    The most common adverse effects reported with lisdexamfetamine were: decreased appetite (39%), insomnia (19%), irritability (10%), decreased weight (9%), and dizziness (5%). Non-significant differences with lisdexamfetamine vs. placebo include: incidences of upper abdominal pain (12% vs. 6%), vomiting (9% vs. 4%), nausea (6% vs. 3%), headache (12% vs. 10%), and xerostomia (5% vs. 0%). The incidence of adverse effects decreased over time. Ten percent (21/218) of lisdexamfetamine-treated patients discontinued treatment due to adverse effects vs.1% (1/72) of placebo-treated patients.
    Urinary acidifying agents (eg ammonium chloride, sodium acid phosphate) increase urinary clearance of lisdexamfetamine, thereby decreasing its efficacy. Since lisdexamfetamine can raise blood pressure, it may decrease the efficacy of antihypertensive medications. The activity of tricyclic antidepressants, meperidine, phenobarbital and phenytoin can be enhanced, so dosage adjustments may be necessary.
    Lisdexamfetamine is contraindicated for use during or within 14 days following the administration of monoamine oxidase inhibitors. Other contraindications include: agitation, moderate to severe hypertension, hyperthyroidism, glaucoma, and patients with a history of drug abuse.
    Lisdexamfetamine is available as once-daily oral capsules in 30, 50, and 70 mg. Tailor therapy to the patient’s individual requirements using the lowest effective dose. The recommended starting dose is 30 mg/day. The dose may be increased by 20 mg/day in weekly intervals to a maximum dose of 70 mg/day. Instruct patients to take lisdexamfetamine in the morning to minimize the potential for insomnia. It may be taken with or without food.
    Lisdexamfetamine is a Schedule II controlled substance and contains a FDA black-box warning about the abuse liability with amphetamines and cardiovascular complications that can result from misuse. Cost data are not yet available for lisdexamfetamine.
    In summary, lisdexamfetamine is an FDA approved treatment for ADHD in children 6-12 years old. It has an extended half-life, allowing once-daily dosing. As a dextroamphetamine prodrug, it may also have reduced abuse liability compared to other current therapies. Clinical trials evaluating lisdexamfetamine are unpublished and were not conducted for longer than 4 weeks.
    References>
    1. Vyvanse™ (lisdexamfetamine dimesylate) package insert. Wayne, A. hire US Inc.; 2007.
    2. Blick SK et al. Lisdexamfetamine. Pediatr Drugs 2007; 9(2): 129-135.
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    Experience Report with Lisdexamfetamine (Vyvanse)- My friend swim did end up giving these a try. She asked me to share her experience with you all..

    Time taken: 7:15 am
    Drug: Lisdexamfetamine 30mg capsules
    Dosage: 60mg (two of the orange and white 30's)
    Route: Oral- capsules intact and taken as directed

    Working on the computer and onset of effects first noted after about 45 minutes of ingestion (T+0:45), after eating a light breakfast of a bagel with hummus and some soymilk. Eyes felt very wide open and awake, whereas they had previously felt tired and wanted to go back to sleep. Also a very sexual horny/feeling, quickie session with multiple orgasms 5-6 and very intense. :) Had some errands to run early morning, which is normally hell for swim, but felt great- very energetic, very talkative when on the phone with people and interacting in public, but not in that "geeked out" way one can sometimes feel on coke or high doses of Adderall (left house around T+1:30, or around 8:45 am and spent about four hours doing errands and such. Overall very comfortable and energetic feeling, and pretty consistent- but not a noticeable rush or overly intense euphoria in any way.. Spent a couple hours driving around town- re-stocking on food and treats for the critters, to the bank, post office, grocery, to help swim's elderly gramps with some things around the house, etc. Got almost everything on the to do list done in one shift, and with no noticeable increase or decrease from that perfect steady energy. Back to swim's place around 1:00pm, or T+5:45- right away decided to do some dope (heroin). Perhaps a bit impulsive from the pills since she has no done heroin regularly in quite awhile. Did a nice shot. Swim felt the great opiate rush and nodded for a little bit, but the amps returned with a vengeance. She would never consider doing a "speedball" ever again, and doesn't touch coke in any form anymore, but she really enjoyed the feeling of the time-released steady up from the pills combined with the wonderful opiate feeling's down. Neither really negated the other, in that swim felt both effects strongly and positively, but the wakefulness effect of the amp definitely took precedence over the sleepy aspect of the dope after the first 10-15 minutes or so. Swim then did some organizing some things around her place- paying bills, making calls, cleaning the apartment, that sort of thing. And spent some time reading as well (T+6-9 hr). At that time swim had to go to a class for a couple hours, so went to that.. not too bad as far as the class went, but she was definitely starting to crash, so took 1 more 30mg Vyvanse(lisdexamfetamine) and 1 200mg Provigil(modafinil) right before the class, and then a 5mg methylphenidate about two hours- halfway- through. She is now officially exhausted, and the drug effects are worn off. She has a bit of a headache and shoulder pain, which could be a come-down/hangover from the upper, but swim thinks its likely just her body's way of telling her she is tired, now that the drugs in her brain aren't convincing her otherwise, as she hasn't gotten the best sleep lately. Oh well, shall catch up tonight, and swim got a ton done today! All around very enjoyable and time seemed to fly. Have not experimented with other routes such as nasal, and am not sure how that would affect someone given the prodrug formulation and the extra l-lysine which is supposedly cleaved from the amphetamines in the gastro-intestinal tract? Who knows? Swim prefers the oral route anyways, as it is smoother, longer lasting, and helps her to function by staying awake and remaining alert. She is afraid if she started using recreationally with such substances, it would likely become both highly addictive (again), and that the specific helpful effects she seeks from stimulant drugs, currently to treat a diagnosed medical condition, would not be compatible with the shorter and more intense rush-crash cycle of intranasal or iv use of uppers. Overall, this drug likely has less abuse potential or recreational value than the more classic and available stims, but is ideal in terms of a long lasting, steady, and strong "boost" for a long workday or a tedious exam. Swim looks forward to hearing from any others who have heard of or tried this prescription drug for add or for other conditions or circumstances, and how they felt about it.

     
    Last edited: Dec 20, 2008
  2. staples

    staples Gold Member

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    This thread got me really interested, so I found three more documents and added them to the file archive, check them out.
     
  3. moda00

    moda00 R.I.P. Platinum Member & Advisor

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    Hey Staples.. am interested to read what you found.. couldn't find it under Adderall, Methylphenidate, or Various Other Drugs- Stimulants in General. Is it under a different heading, or perhaps not posted yet?? Let us know- thanks!!

    EDIT: whoa ok I am slow.. the reason it wasn't turning up in my searches was because I was spelling it wrong!! But I found a few older posts from December 2007, but the archive didn't turn up- not sure if the search searches forums only or archive documents too? Anyways, sorry if I overlooked something.. but let me know or maybe post a link to help the computer-illiterate like myself? ;) Thanks..
     
  4. Bajeda

    Bajeda Platinum Member & Advisor

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    Under the Search drop-down menu there will be a number of options. There is one specifically titled Search Files, Video & Audio in the middle cluster of links that will search the archive.
     
  5. moda00

    moda00 R.I.P. Platinum Member & Advisor

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    Thanks Bajeda.. a little out of it today, lol, psychology class fried my brain.. just kidding. Also, I did check out a few other posts on this drug, as I overlooked them before when making the original post due to spelling error in the drug name.. I replied to one as it seemed to potentially contain some dangerous comments and very little facts, and linked to this thread.. Not sure if they should be combined, due to their similar content.. or not combined, due to the possibly incorrect/dangerous comments made there? Your call (or maybe not.. I don't think you are the mod here lol..) :) Either way.. thanks for the heads up.. am interested in learning more about this substance as it seems very different from the other drugs of its type that are available today, and seems very few people have encountered it yet. Link to other thread is http://www.drugs-forum.com/forum/showthread.php?t=43001&
    Have a good one!!~
     
  6. no-go

    no-go Silver Member

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    This is just another invention to prevent "abuse" of stimulants. Read it, it is inactive on its own and requires conversion, must be ingested, not insufflated nor sublingual. It does not look as effective as equivalent amounts dextroamphetamine.

    I think the poster's friend was suffering from a bit of placebo. Swim suspected it at first, because amp's are not better than MPH for euphoria (though probably for long-lasting ADD/ADHD control). Apparently this drug has no benefits over d-amp except to calm concerned mothers everywhere and stimulate interest ONCE AGAIN into ADHD, i.e. to make money.
     
  7. staples

    staples Gold Member

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    So what is the equivalence based on?

    This is certainly different depending on the person, and this in particular seems to be against the popular opinion... I, for one, disagree, at least.

    What about the longer-lasting effects? Making it so kids do not have to be interrupted in the middle of class to take their medication prevents socially awkward development. Would you not also say abuse prevention is a good thing?

    As an update, I think I may be switching to vyvanse from concerta/ritallin (methylphenedate) next week, so if that happens I'll post more thoughts on the subject.
     
  8. IntrepidTraveler

    IntrepidTraveler Silver Member

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    SWIM disagrees. He has extensive experience with every ADHD medicine under the sun--been perscribed various d-amps (dexedrine, adderall IR and XR, etc) and methylphenidate (ritalin, concerta) for years and finds Lisdexamfetamine (Vyvanse) very useful. The forumulation makes for controlled, constant effects, which is ideal for studying and treating SWIM's general ADHD symptoms. One might not feel the same "peak" with Vyvanse as he feels on d-amps or methylphenidate, but Lisdexamfetamine--in SWIM's experience--produces a unique, calmer euphoria than other ADHD drugs. Even on relatively high doses (200+ mgs), SWIM doesn't feel "cracked out," which makes for a much more social high. Basically, don't knock it until SWIY has tried it.
     
  9. staples

    staples Gold Member

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    In addition to the current dosages, new dosages of 20, 40, and 60mg's are now (somewhat) available.

    My doctor started me off with a prescription for 20mg vyvanse to be increased to 40, but no pharmacy in this area has it. Most quoted a necessary 2 week period before they could have any of this particular dosage available (doesn't seem right...) but I found one that said they'll have it tomorrow.

    Edit it TURNS OUT, that that was too good to be true. The pharmacist explained to me that Shire is just starting to release to distributors and they will have to have Shire drop ship an order directly to my pharmacy before I can get my prescription filled... well, I hope it's worth the wait, methylphenidate has been consistently making me feel sick lately.
     
    Last edited: Mar 7, 2008
  10. staples

    staples Gold Member

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    Sorry to doublepost but I think this reply warrants separation from the last.

    My doctor tried to write me a 20 mg prescription for vyvanse early this month, to be taken for a week and then increased to 40 mg, but no pharmacies had this dosage, as it's a new dose (see post above), and they would not be able to get it for somewhere on the order of two weeks.

    Normally I wouldn't care too much, I still had methylphenidate (concerta/ritalin -- I was only about a week into a months' worth, my doctor said to have it in case I didn't like vyvanse). but methylphenidate makes me feel sick very often, and it was a good week in terms of school to change medication, so I called my doctor and exchanged the 20mg strength prescription for a 30mg one.

    She was explaining how to open the capsules in case I wanted to play with my dose a bit or try to follow the original 20mg to 40mg instruction, but the prescription itself didn't call for any dose modification so I wasn't sure at first. The next day when it was time to try it, I decided to try dumping some out to start at 20, just in case (knowing the effects will last all day, whether I like them or not, is something I tend to be cautious about). As I pulled apart the capsule, white powder immediately fell into my hands as if the pill had been packed so tightly that it contained more drug than could fit in one side of the capsule -- or perhaps there was a bit of suction from separating the capsule? At any rate, being unable to make a good estimate since I couldn't quite visualize the full amount, I just put the capsule back together and took it.

    After a few weeks of taking 30mg vyvanse, it just didn't seem all too effective and I didn't get a lot of work done (sorry alfa, btw), so just the other day my doctor wrote me a 50mg script, though I feel like I may want to go up to 60 next time, I'm not quite sure yet.

    I have to say: I love everything about vyvanse. I love that it cannot be insufflated or really abused unless one is willing to experience the effects all day (I imagine that'd be hell for the body). Unabusable means I am not solicited with attempts to purchase my medication... well, also I guess not many people are familiar with it yet. I am personally intrigued by the fact that the very same modification which makes vyvanse less abusable, gives it the amazing and unique time-release characteristic that it has.

    Perhaps somedays I would prefer it to kick in a little quicker, but the subtlety achieved by the very gradual time-release is worth the wait. It's almost as if my brain doesn't associate the effects with the pill -- they truly creep up on me, every day. And then, come 10 or 12 hours later, I can't even tell if it's fading out or not. Most of all, and perhaps for psychological reasons (cognitive dissonance?), it's much more transparent than any other medication I've been on -- I am very much less aware that I'm "on" something.

    The cognitive dissonance, if that's what it is, is probably the underlying idea -- the drug helps concentration without the person necessarily expecting it to. If I think about it during the day, I realize I feel very similar to when I was on adderall, but there's a prevalent feeling of normalcy. I really think this is a case of the brain thinking "hm, that didn't do anything, it must not be a drug" after taking vyvanse, and then after forgetting about it the dextroamphetamine does its thing. But the brain is, to some degree, still convinced that it is unaffected and thus maybe doesn't do such things as raise the heart rate too much, and so on (...umm..schachter's theory of emotional response? I think?).

    Also, my doctor told me that Shire is pushing to get vyvanse into a lower controlled substance schedule, which would mean refills! Exciting news all around.

    I would definitely recommend vyvanse to anyone who didn't have terrible results with amphetamines (adderall/dexedrine) but perhaps didn't like the "ups and downs," or if they experience sick feelings on methylphenidate (concerta/ritalin) like myself.
     
  11. highguy

    highguy Newbie

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    swim has messed around with this and researched before.
    the only way this drug can be absorbed is when it goes through the digestive system.
    even then its not very good to use recreationally.there's a limit to how high one can get on this. it made swim hallucinate at high doses
     
  12. doggy_hat

    doggy_hat Newbie

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    SWIM was prescribed 30mg Vyvanse for a short time. He tells me that the time release didn't really work for him at all. About an hour after taking the medication it'd be working well. But after about 2-3 hours effects where almost gone and after 4 hours he felt like he hadn't taken the pill at all. He also found the physical buzz that he got from taking it with no tolerance, or once when he double dosed for an essay, to be rather unpleasant. SWIM would be tempted to consider the physical aspect of Vyvanse to be disphoria instead of euphoria.

    Can anyone else report similar experiences?
     
  13. emoduckie

    emoduckie Newbie

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    for rec uses, which adhd drug (Adderall, Vyvanse, etc) is the most effective?
     
  14. moda00

    moda00 R.I.P. Platinum Member & Advisor

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    Well, this particular thread is about Vyvanse. If you read through this thread, you'll see a variety of account of Vyvanse in contexts of therapeutic intent by those taking it (sleep disorders/hypersomnia, ADD/ADHD, etc.) as well as general productivity, which one might consider recreational, but perhaps not in the context swiy is implying so much.

    One would be hard pressed to tell you which stimulant is "most effective," as each has their pros and cons, but if I hear the term "recreational," I tend to think quicker and more bioavailable routes of ingestion (ie. snorting or smoking or injecting, versus normal oral use), and a good peak/high/rush of some sort. With regard to those things, you can find a lot of info from previous posts, but it seems most posters, swimself included, would not see Vyvanse as being particularly ideal for recreational use. It cannot be "abused" by snorting it and it has a very gradual/subtle and long lasting effect- the same traits which make it ideal for hypersomnia, ADHD, getting things done for school or work, etc. might make it less ideal for partying, getting high and such.

    As for the others, there is plenty of info around on each- use the forum search! It comes down to the fact that it really is a matter of personal preference when comparing the traditional amphetamine stimulants (Adderall, Dexedrine, etc.) to methylphenidate (Ritalin, which is often linked to these but structurally differs a bit from amps). Many people find both suitable for recreation, moreso than Vyvanse which is simply a pro-drug formulation of an amphetamine, but if you browse the forums and threads that are specifically about each of these substances you may get a better feel for the individual effects and subtle differences.
     
  15. Boca Bitch

    Boca Bitch Newbie

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    To the OP (original poster):

    SWIM has experienced vyvanse, adderall, dexedrine, and cocaine recreationally. Also, SWIM has done considerable research on their effects.

    I'm afraid your friend may be experiencing a "placebo effect," by telling himself that vyvanse is similar to the functions of cocaine/crack. Cocaine is known to trigger a substantial release of the neurotransmitters dopamine, neuropinephrine, and serotonin. Both dopamine and serotonin in high amounts result in the feeling of euphoria, but it's the presence of serotonin that gives cocaine its distinctive euphoric high to the user.
    Adderall, when abused, has potential to give the user a sense of euphoria becuase of the flood of dopamine it creates in the brain, and further more, high amounts can trigger a small release of serotonin.
    Vyvanse on the other hand, is specifically formulated to be a non-euphoric drug in order to reduce abuse potential. Lisdexamphetamine has the least interactions with serotonin out of all the amphetamine isomers, and attempts to even out levels between dopamine and neuropinephrine. The higher neuropinephrine to dopamine ratio, results in an abuser feeling more "on edge" than "high." Neuropinephrine triggers the "flight or fight" response in the brain, counterbalancing the focused, yet euphoric effects of dopamine.

    SWIM knows... a Vyvanse high is not nearly as fun as Adderall, or cocaine for that matter. :p
     
  16. e4rolls

    e4rolls Newbie

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    SWIM agrees that Vyvanse does not give a good recreational "high". The GI tract does not contain/produce enough of the enzyme that is need to cleve lysene off the entire dose of Vyvanse at one time.

    So the max that can be broken down to active amphetamine per hour is around 100mg lisdexamfetamine.
    So according to Shire, taking more than prescribed does not increase blood syrum levels for a stronger peak but instead, just extends the duration of the medicines effects.

    The higher the initial dose of lisdexamfetamine, the longer the duration of effect.
    SWIM has tried taking multiple doses of 50mg at a time but never could achieve as strong a euphoria as when taking several doses of dexamphetamine.
    SWIM was awake all night on the higher doses of Vyvanse- that's about it.
     
  17. doggy_hat

    doggy_hat Newbie

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    Is it possible for someone to natural possess more of these necessary enzymes, because as I've stated in my earlier post in this thread, SWIM only felt effects for a few hours. He prefers vyvanse over concerta(his current script) after he's developed enough tolerance to not feel a body buzz anymore. But I guess since it's so new, doctors just prefer to stick with something more reliable, than give a twice a day script to combat the short duration from SWIM's abnormal reaction.
     
  18. e4rolls

    e4rolls Newbie

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    Yes it is possible because many others have reported the same as you have in your posts. It is always going to be true that not everyone responds the same to every medicine and all metabolisms are different.
    I hope SWIY gets prescribed the right medication to cover symptoms the entire day.
     
  19. Boca Bitch

    Boca Bitch Newbie

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    AND an increased risk for coronary failure, or other complications (i.e. dehydration, hallucinations, increased agitation).

    Please do not attempt an insanely high amount of Vyvanse to achieve a high.
     
  20. betsym

    betsym

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    Swim has taken IR Adderall since 2000 and recently tried a free-month trial of Vyvanse. At swim's doctor's office, the pharmaceutical rep that brought the samples told swim's hubby that Vyvanse was made to lessen abuse potential. She tried it, the lowest mg, 50 mg,and didn't like it. She normally takes 5 mg doses of her Adderall but 50mg of Vyvanse seemed like nothing. This was puzzling. Due to the expense,and the fact it didn't work as well for her, she only took the free-month. Others have said the same thing that she asked about it afterward so the company may have to tweak the formula a little bit or something because it doesn't seem to work well enough to warrant such a high price. Others may like it. It didn't do much for swim's ADHD, though.