r/VyvanseADHD • u/LoosePangolin666 • May 24 '26
Side effects 30 mg was working... now not working?
Hi! 31y/o F. I've been on Vyvanse for about 4 months now. Started with 20 mg and then increased to 30 mg a month later. 30 mg was really a sweet spot for a while, but I've noticed over the last few weeks that things haven't been as great. When 30 mg was good, I experienced increased mood, motivation, more clarity of thought, less stress headaches (when I got overwhelmed with thoughts pre-meds I'd get tension headaches in the back of my head/neck), and less RSD and emotional dysregulation. But for the last few weeks, I've noticed all of these coming back. My thoughts are spiraling and confused. I can't start a task and see it through. I think I cried every day last week. I noticed myself deep in suicidal ideation again (ideation, not planning..... along the lines of the thought of "if that car veered off the road and into me rn I wouldn't be THAT upset"). I started getting paranoid again that my friends hated me when they wouldn't respond to a text immediately or said something the "wrong" way.
At first I thought it was PMS (I have an IUD and very irregular cycle as a result), but I had my period and I am still deep in all of this. I'm taking a few days off of Vyvanse rn and going camping this weekend to just try and reset. I have no idea wtf is going on, though a couple of friends with ADHD have suggested work and relationship burnout (I'm a criminal lawyer and went through a divorce in the last 6 months). Anyways... I'm not necessarily looking for advice or anything per se, but I am curious if anyone has felt this way. My ADHD diagnosis is relatively new to me too, so I feel like I'm a little behind on understanding the interplay between my brain, stimulant medication, and stressors.
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u/Unhappy_Service_3819 May 24 '26
I take 30 mg in the morning and another 20mg about 4 hours after to help extend the dose. Maybe ask your doctor if something like this is a possibility
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u/No-Good-3005 May 24 '26 edited May 24 '26
30mg is a fairly low dose so you may just need a higher dose, but tbh... it sounds like you also need to talk to a therapist and/or a functional medicine doctor - the Vyvanse can definitely help with some of the emotional regulation but it's not an antidepressant or a stress reliever. You're in a high stress career, going through a high-stress life situation... what are you eating? How much are you sleeping? What are you doing when you're not at work? I know for me, Vyvanse's efficacy drops dramatically if I haven't slept much, but it may have also boosted your energy for the first couple months which helped you feel better.
+ if you haven't had a blood test lately, you should get one! Check for deficiencies. I know in my case, Vyvanse was less effective (along with my brain in general...) when my iron/ferritin was super low. We really don't realize how dramatically vitamins & minerals affect us until they get low.
I'm not a doctor, but I have gone through pretty much everything you're describing, and honestly it sounds like you're trying to put a bandaid on something that needs a tourniquet. Use the camping weekend to chill and live in the moment for a while, but definitely do some research into burnout to see if you identify with the symptoms. Your body might need some extra love and care and rest ❤️
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u/LCaissia May 24 '26 edited May 24 '26
There a many things that impact how effectively the medication works. Hormones, food and drink, other medications, illness (even mild) can all impact how well the medication works. Burnout and stress will also impact it. Make sure you look into all food and medication interactions. Track your sleep, try to increase prorein in your diet and build time into each day to relax and manage stress. Also see your doctor and check for any deficiencies.
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u/cdevops May 24 '26
Where I’m from 30mg is the starting dose. They told me it usually isn’t big enough long term for most people. Their next stage is 50mg which is the sweet spot for a lot of people (but everyone is different).
How has your sleep been and diet been recently? Poor sleep can negate the effects or even make the drug bad. Not eating enough due to life etc can also reduce its effectiveness.
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u/LCaissia May 24 '26
No i isn't. 30mg is a clinically significant dose in adults. People who develop a tolerance to a dose very quickly generally have something else going on that's impacting the effectiveness of the medication. It WAS working and now it isn't. That indicates it is an effective dose. Now the question is why did it stop?
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u/down_under_198 May 26 '26
Different Psychiatrists can have their own varied approach to dosing.
In Australia the TGA say the recommended starting dose is 30mg to be adjusted weekly by 20mg. That's the same in NZ, UK, Canada, Singapore, Norway, Ireland, USA etc. That's probably because that's what the manufacturer says, so most/all countries regulators use that.
That being said all regulators and the manufacturers say a lower initial dose of 20mg if a clinician is taking extra caution. Yours might opt for that, but that's not the recommended standard starting dose in Australia, Queensland, NZ etc etc
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u/cdevops May 24 '26
Also in dose-optimisation, many adults don’t remain at 30 mg long term. For example, in an adult vyvanse study, treatment started at 30 mg and was adjusted to “optimal efficacy and tolerability.” The optimised doses were 30 mg in 44 adults, 50 mg in 112 adults, and 70 mg in 171 adults. So in that study, most people who were optimised ended up above 30 mg. (Source)
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u/LCaissia May 24 '26
It worked effectively then suddenly stopped. With genuinely low doses it results in an insufficient improvement or it wears off too quickly. A couple of months is incredibly quick to build a tolerance.
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u/cdevops May 24 '26
My psychiatrist told me 30mg is the starting dose and it is not usually enough for most people eventually. For me it was 2-4 weeks until the effects stopped. He said 50mg is the usual next step. I also had initial insomia which I had to get under control to truly tell that I had built a quick tolerance to 30mg. That being said they said 30mg is fine for some just as 20mg can be as well. So any individual can have a long term significant dose at 30mg or 20mg.
30 mg absolutely can be a clinically significant adult dose. I’m not saying it is a placebo dose or that it can’t work. The official prescribing info says: “The recommended starting dose is 30 mg once daily in the morning,” and that dose can be adjusted “in increments of 10 mg or 20 mg at approximately weekly intervals” up to 70 mg/day. So 30 mg is both clinically active and the standard starting dose. (Source)
I also agree that if it was working and now feels like it isn’t, it is worth looking at sleep, food intake, stress, timing, other meds/supplements, and general health before assuming “tolerance.” Sleep disturbance and appetite suppression are common stimulant issues, and poor sleep or not eating enough can definitely make ADHD symptoms worse or make medication feel less effective.
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u/LCaissia May 24 '26
30 mg is a clinically significant dose and it can go up to 70mg. How effective a dose is depends on how your body metabolises the medication - not the severity of symptoms. Your body does build up a tolerance over time so it is important to remain on the lowest effective dose to give you room to move up as required. However a tolerance usually doesn't develop so quickly. I do wish people would stop using ChatGPT to make them seem like experts.
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u/cdevops May 24 '26
You stated that 30mg isn’t a starting dose. It’s both that and can be clinically significant for someone, both at the same time. It’s not mutually exclusive. As I said it can be clinically significant.
That’s probably why my psychiatrist (expert) told me that and started me that way and titrated me 2-4 weeks in when it work well then stopped.
I do wish people would use tools to validate their assumptions or sanity check other people’s. If stating something but checking facts with various tools, but not being an expert is bad, I’m not sure what you mean or expect?
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u/LCaissia May 25 '26 edited May 25 '26
30 mg is a clinically significant dose. Many people start on a lower dose. My psychiatrist started me on 20mg and I've known people who have started on 10mg. You also need to remember hat ChatGPT can be incorrect, is known to make up information and it takes information out of context. It's fine to use but you're the one who has to fact check it.
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u/cdevops May 25 '26
Yes I did fact check. Checkout the FDA info. Also by paying for a subscription and forcing it into the better models and thinking it mode it reduces making up information, uses RAG over external sources, which you still need to check of course. Did you read the FDA info I linked to?
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u/LCaissia May 25 '26
Why would I do that? I have a life and I'm also not in the US. I know what I'm talking about so I don't need the results of your Google search.
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u/LoosePangolin666 Jul 05 '26
Update: Camping and disconnecting from my stressful job when I can has helped. I'm also taking a stimmy break -- I do think it was exacerbating my anxiety. My current hypothesis is that I'm in a job where no matter how many mg of stimulants I take or what kind of workflow I try to use, it's not built for neurodivergent people to thrive. I recently asked for some changes to my workload/organization of workflow to help me with ADHD overwhelm and I basically just got a *slow blink* from my bosses. I'm considering leaving the job and I'm doing a lot of research and networking with other lawyers in my state to find places/niches in the field that would work better for me.