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I need adderall to function but on my last refill the pharmacy was out and when I asked when they’ll get more the tech said “maybe next year?”. I got my doc to

I need adderall to function but on my last refill the pharmacy was out and when I asked when they’ll get more the tech said “maybe next year?”. I got my doc to switch me to vyvanse which is 3x the price even with good insurance since it’s still brand only. I don’t like vyvanse compared to plain generic adderall but I’ll take what I can get. Seems like they’d make dispensing it harder rather than just cut off the supply to everyone.

slaymaker1907 4y ago
Personally, while I don't take either now, I could never go back on Vyvanse due to the severe appetite suppression I experienced on that medication which I did not have with Adderall. These medications are not completely interchangeable.
- eyelidlessness 4y ago
  How much they vary seems to be very patient specific (perhaps amplified or muted by their relative dosages? ie Vyvanse max of 70 is supposed to be comparable to Adderall max of 60). I personally experience just the same appetite suppression with both (severe, although if I actually put a bite of food in my face it can sometimes “break the spell”). But I know other people notice the difference more like you do. They’re definitely not interchangeable, but how much so might vary from deal breaker as it is for you, to basically indistinguishable as it is for me (at least on the appetite suppressant topic). Not meant to argue, I just don’t want to unnecessarily dissuade people who might be having trouble filling Adderall and weighing the possibility of temporarily substituting so they have something to fill the gap.
- opportune 4y ago
  Completely agree, for me Vyvanse lasts longer than two-dose adderall IR and XR, which affects my sleep and appetite a lot. Basically the release is more spread out, so it’s less effective when its at its peak, even though the actual metabolized d-amp is higher than I was at formerly with IR. It’s also a lot more expensive for me. I hate it, but it’s all I can get. The wonderful medical experts at the DEA have my gratitude for coming up with such an excellent solution to the scourge of telehealth. I’m sure they did a thorough analysis weighing disrupting/ending millions of stable ADHD patients’ treatment against the possibility of someone getting medication they might not need.
bnjms 4y ago
Vyvanse is AKA lisdexamphetamine which is a slow release form of dexamphetamine AKA dexadrine. The Astral Codex guy says patients prefer dexadrine and patient reports suggest it lacks some of the body affects. All to say maybe try the cheaper dexadrine twice a day.
- opportune 4y ago
  Dexedrine is also facing supply issues. Really all stimulants are but it seems to affect IR medications (and XR adderall) the most, likely because adderall IR was the first be impacted and then patients switched to other IR medications or the XR version.
- sph 4y ago
  Good, body effects should not be present in ADHD medication. I like Vyvanse because it does not affect my heart or blood pressure. It's like coffee for the brain without the jitters. And since it takes hours to peak, there is never a come up feeling one might associate with it and derive pleasure from. I take it, and eventually after a couple hours I find I am well awake and present more than any coffee, yet still feeling very calm and at ease. That said, I take the lowest effective amount (20+20mg) which requires good sleep and good diet to be effective. So it never turns me into a productive robot, and I have to accept that some days are a bit lower-energy.
clubsoda 4y ago
Have you considered gaunfacine? https://medlineplus.gov/druginfo/meds/a601059.html https://medlineplus.gov/druginfo/meds/a601059.html I had long suspected I had ADHD. After covid, my brain became wrecked. I wanted to go with something non-addictive due to my checkered past. Easily would recommend, as long as you don't have terribly low blood pressure. NAD.
- elcritch 4y ago
  Another thing to try is NAD+/CoQ10 supplements. I had some brain fog after covid (I'm officially diagnosed) and NAD+ seemed to help a ton. I had researched the brain fog with covid 19 and found a lot of research pointing to NAD+ / mitochondrial disruptions as source of brain fatigue [eg 1]. NAD+ supplements are well studied for anti-aging too. So it seemed to have a high probability of helping. 1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234841/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234841/
  - TurkishPoptart 4y ago
    How to increase one's NAD+ levels?
    - elcritch 4y ago
      The NAD+ supplements can increase it according to a few research articles I've found. IIRC, it's like 10-20% increase in some cases. I also added CoQ10 as it works together with NAD+.
      - TurkishPoptart 4y ago
        Andrew Huberman talks about this, but to increase it using NMN or another supplement, which are now off the market.
tiedieconderoga 4y ago
Not medical advice but IIRC, Vyvanse is essentially the name-brand product with an extra methyl group stuck on. Your pancreas produces an enzyme called Trypsin that breaks off that methyl group, and turns it into the active ingredient. It's considered an extended release because the enzyme's availability is limited in your body. Trypsin is not exactly a common supplement, but you might consider looking into which kinds of foods can inhibit or encourage its production. Grains and cereals will probably inhibit it, unfortunately.
- johnnyjeans 4y ago
  Lisdexamfetamine is the right-handed dextroamphetamine with an L-Lysine amino acid attached to the nitrogen atom. Regular adderall is a mix of the left and right handed enantiomers of amphetamine.

slaymaker1907 4y ago

Personally, while I don't take either now, I could never go back on Vyvanse due to the severe appetite suppression I experienced on that medication which I did not have with Adderall. These medications are not completely interchangeable.

eyelidlessness 4y ago
How much they vary seems to be very patient specific (perhaps amplified or muted by their relative dosages? ie Vyvanse max of 70 is supposed to be comparable to Adderall max of 60). I personally experience just the same appetite suppression with both (severe, although if I actually put a bite of food in my face it can sometimes “break the spell”). But I know other people notice the difference more like you do. They’re definitely not interchangeable, but how much so might vary from deal breaker as it is for you, to basically indistinguishable as it is for me (at least on the appetite suppressant topic). Not meant to argue, I just don’t want to unnecessarily dissuade people who might be having trouble filling Adderall and weighing the possibility of temporarily substituting so they have something to fill the gap.
opportune 4y ago
Completely agree, for me Vyvanse lasts longer than two-dose adderall IR and XR, which affects my sleep and appetite a lot. Basically the release is more spread out, so it’s less effective when its at its peak, even though the actual metabolized d-amp is higher than I was at formerly with IR. It’s also a lot more expensive for me. I hate it, but it’s all I can get. The wonderful medical experts at the DEA have my gratitude for coming up with such an excellent solution to the scourge of telehealth. I’m sure they did a thorough analysis weighing disrupting/ending millions of stable ADHD patients’ treatment against the possibility of someone getting medication they might not need.

bnjms 4y ago

Vyvanse is AKA lisdexamphetamine which is a slow release form of dexamphetamine AKA dexadrine. The Astral Codex guy says patients prefer dexadrine and patient reports suggest it lacks some of the body affects. All to say maybe try the cheaper dexadrine twice a day.

opportune 4y ago
Dexedrine is also facing supply issues. Really all stimulants are but it seems to affect IR medications (and XR adderall) the most, likely because adderall IR was the first be impacted and then patients switched to other IR medications or the XR version.
sph 4y ago
Good, body effects should not be present in ADHD medication. I like Vyvanse because it does not affect my heart or blood pressure. It's like coffee for the brain without the jitters. And since it takes hours to peak, there is never a come up feeling one might associate with it and derive pleasure from. I take it, and eventually after a couple hours I find I am well awake and present more than any coffee, yet still feeling very calm and at ease. That said, I take the lowest effective amount (20+20mg) which requires good sleep and good diet to be effective. So it never turns me into a productive robot, and I have to accept that some days are a bit lower-energy.

clubsoda 4y ago

Have you considered gaunfacine? https://medlineplus.gov/druginfo/meds/a601059.html https://medlineplus.gov/druginfo/meds/a601059.html I had long suspected I had ADHD. After covid, my brain became wrecked. I wanted to go with something non-addictive due to my checkered past. Easily would recommend, as long as you don't have terribly low blood pressure. NAD.

elcritch 4y ago
Another thing to try is NAD+/CoQ10 supplements. I had some brain fog after covid (I'm officially diagnosed) and NAD+ seemed to help a ton. I had researched the brain fog with covid 19 and found a lot of research pointing to NAD+ / mitochondrial disruptions as source of brain fatigue [eg 1]. NAD+ supplements are well studied for anti-aging too. So it seemed to have a high probability of helping. 1: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234841/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234841/
- TurkishPoptart 4y ago
  How to increase one's NAD+ levels?
  - elcritch 4y ago
    The NAD+ supplements can increase it according to a few research articles I've found. IIRC, it's like 10-20% increase in some cases. I also added CoQ10 as it works together with NAD+.
    - TurkishPoptart 4y ago
      Andrew Huberman talks about this, but to increase it using NMN or another supplement, which are now off the market.

tiedieconderoga 4y ago

Not medical advice but IIRC, Vyvanse is essentially the name-brand product with an extra methyl group stuck on. Your pancreas produces an enzyme called Trypsin that breaks off that methyl group, and turns it into the active ingredient. It's considered an extended release because the enzyme's availability is limited in your body. Trypsin is not exactly a common supplement, but you might consider looking into which kinds of foods can inhibit or encourage its production. Grains and cereals will probably inhibit it, unfortunately.

johnnyjeans 4y ago
Lisdexamfetamine is the right-handed dextroamphetamine with an L-Lysine amino acid attached to the nitrogen atom. Regular adderall is a mix of the left and right handed enantiomers of amphetamine.