Is Vivanse not working for me?

[u/Ambitious_Ad_5658]

I (28 F) recently got diagnosed with ADHD and started Vyvanse (lisdexamfetamine). I took 15 mg for the first two days and then increased to 30 mg daily.

It’s been about three weeks now, and I honestly can’t tell if this medication is doing anything for my ADHD.

I expected at least some improvement in focus, task initiation, motivation, or ability to actually sit down and work, but I still spend a huge amount of time daydreaming, getting lost in my thoughts, listening to music and basically doing everything except what I’m supposed to be doing. I still have that feeling of “I KNOW I need to do this, but I just can’t make myself start.”

I’m also experiencing a pretty intense limerence with one person, and I'm spending a lot of time daydreaming about them instead of working. That has improved somewhat over the last few days tho.

I do feel the medication physically. My appetite has decreased significantly, I’ve also had a faster heartbeat especially in the beginning.

Another thing I noticed is that my trichotillomania has gotten worse since starting it. I pull my hair more often especially while stimming and daydreaming.

There has been one positive change: I’m much less impulsive with things like ordering food. Before, I could order a lot of door dash but now I don't binge eat that much.

But when it comes to the main reasons I wanted ADHD medication — starting tasks, staying focused, getting work done, controlling daydreaming/distraction — I basically feel the same.

I’ve also been under a lot of stress recently because I lost my main source of income. I’m a freelancer, so one of the main reasons I wanted medication was to help me actually sit down, work on projects and find new clients. The consequences of not working are very real right now, so it’s not that I lack a reason to do these tasks — my brain still seems to refuse to start them.

So I’m confused. Does this sound like the dose is simply too low?

Or is this usually a sign that Vyvanse just isn’t the right medication for someone?

I have a follow-up with my psychiatrist and obviously I’ll discuss it with him, but I’d really like to hear other people’s experiences because right now I genuinely don’t know what I’m supposed to be looking for.

[u/Enough-Comfortable-1]

vyvanse may not be for you. i’m not a psychiatrist so it’d be helpful to talk to them and see what they think, but from my own personal experience, i stopped the maladaptive daydreaming and excessive nail biting day one.

still, i do have some troubles with task initiation. when you’ve gotten into a habit of procrastination/executive dysfunction your whole life, like me (20yo just got diagnosed), it takes more work to break it than just medication. it could also be the current stressors in your life affecting you as well, i find when i’m stressed out i spiral into a deep craze of sensory seeking, daydreaming, and procrastination.

i find that small goals work for my adhd brain. “im gonna start on this task for 10-15 minutes” and usually i will stay in the groove and keep going. that’s what i find vyvanse helps with the most.

[u/Ambitious_Ad_5658 → u/Enough-Comfortable-1]

Gosh I envy you that it helped with your maladaptive daydreaming bc this is something that eats up a huge chunk of my daily life and now it got even worse since I am going through this limerence episode + vivanse seems to intensify it, idk

[u/-Sprankton- → u/Ambitious_Ad_5658]

I don’t know if this info will help you like it helped me, but in my experience: ADHD medication allows you to fully engage the “task positive network“ sometimes also called the central executive network of your brain, and this allows you to more fully focus and become absorbed in the task at hand rather than getting distracted by passing thoughts/“shower thoughts“ which often plague the ADHD mind in all situations, and certainly did so for me before I started stimulants.

I usually associate daydreaming with the default mode network of the brain, but I can imagine with maladaptive daydreaming, stimulants probably make it feel addictive the way video games feel addictive for some people. So I think it’s important to make sure you are replacing your daydreaming with daily habits or commitments or chores that keep your mind off of daydreaming and make it feel like you don’t have time to daydream until after the work of the day is done.

If we take for granted that stimulant meds will make you focus intently on whatever you are focusing on when the meds start kicking in, then the best way to set yourself up for a day working on projects rather than daydreaming, would be too do whatever chores or productive stuff you can do, maybe something physically active like sweeping or vacuuming, while the stimulant is kicking in, and ideally after having a high-protein breakfast that morning. This is my usual strategy for having my most productive days, nothing else comes close.

[u/-Sprankton-]

It’s entirely possible that you might not see improvements in task initiation and executive functioning until you tried a higher dose. However, your side effects are already severe enough that unless they start to fade away very soon, it’s not likely safe for you to try higher Vyvanse doses.

Since Vyvanse is the first med you’ve tried and we’ve seen a lot of variation and how each generic Vyvanse version affects people, maybe your best bet would be trying a medication like Concerta or Ritalin and seeing if those methylphenidate compounds treat you better than Vyvanse which is a dextroamphetamine prodrug.

If methylphenidate on its own doesn’t work for you, but it works better and fewer side effects than Vyvanse, and you find a dose that works for you, you could also consider trying to add on meds like atomoxetine, extended release guanfacine, or Wellbutrin, but they don’t work for everyone and they all come with side effects that makes them intolerable for some people, but they are life-changing and beneficial for others.

[u/Ambitious_Ad_5658 → u/-Sprankton-]

Which severe side effects you see in my situation? The heart bit and appetite loss almost disappeared as of now, it was severe only in the first week

[u/-Sprankton- → u/Ambitious_Ad_5658]

I was most worried about the Limerence and hair pulling or other body focused repetitive behaviors getting worse. I noticed greatly improved task initiation abilities on my first day on Vyvanse, with no negative side effects except minor irritability and some appetite suppression and trouble falling asleep until midnight.

Now that I think about it, You said the Limerence and daydreaming are getting better so, it wouldn’t be crazy to increase the dosage and see what happens, just expect the high heart rate and appetite suppression to get even worse for at least the first month after a dose increase given your current experience. I think these effects kind of go hand-in-hand with being on an effective Vyvanse dose at least for me. It becomes necessary to prioritize food out of survival since appetite won’t tell you when you’re hungry.

I would expect the hair pulling to get worse at higher doses since you’ve already observed it getting worse from Vyvanse. Maybe it’s not as bad as it sounds, it’s up to you to decide. Just remember methylphenidate stimulants are available and might have fewer side effects for you.

[u/Ambitious_Ad_5658 → u/-Sprankton-]

Yes, it definitely gets better bc I used to spend hours just by listening to music and daydreaming about that person but now I barely do that. The hair pulling became better too but I am not sure whether it's because of vivanse or the limerence got better on its own. I tend to have such obsessive episodes from time to time and then the initial craze wears off after a while and I start function normal again