Hello...I was hoping for some advice on what others have done when stimulants just don't seem to work at all. I started on Effexor, then Ritalin immediate release until I was on the max dose of that, switched to Concerta and kept moving up until the max dose, now on 30mg of Vyvanse and still no change at all. I have still had micro sleeps and full sleep attacks after taking all of these and still don't feel any more energized whatsoever. I have been off and on medical leave from work while I try out different meds with no success and I feel hopeless. If I can still pass out after taking the maximum dose of multiple stimulants then how am I ever going to be a normal functioning member of society? I'm at the point where I can't drive anymore and I'm scared to cook sometimes because I've fallen asleep while baking. The next thing I think we're gonna try if Vyvanse doesn't work is Adderall but from what I understand, they're pretty similar. Are there any other medications that have helped with sleep attacks throughout the day and energy? I'm hoping to avoid Xyrem because my insurance has already made this hell from the beginning with all the stimulants and it seems like that's even harder to get approved for. I'm hoping there are others I maybe haven't heard of yet? Sorry this is so long, thank you for reading/listening.
Nacia
I was maxed out on Nuvigil and Vyvanse and still exhausted with horrible brain fog. I was desperate so I tried Xyrem and it changed my life. No more exhaustion, no more sleep cravings or brain fog. I have good days everyday. I feel great. I feel normal and alive again.
Mis
I haven't tried Provigil or Nuvigil yet, so I'm hoping to try those before Xyrem. I will try Xyrem as a last resort if nothing else works, but I know my insurance is going to make me jump through hoops for it. Getting Vyvanse was already really hard.
Becky
If your meds don’t seem to be working, or have bad side effects, you might benefit from genetic testing that is medication-specific... There are three classifications that are included in the test, with a list of which meds will and won't work.... Stimulants, psych meds, and pain meds with the ADHD and psych panels... The test shows your individual enzyme make-up, which affects how you metabolize medications.


I had the test done, and it explained a lot about why some meds don't work for me, and others have bad side effects...

Most insurance companies do not pay for the test. But they do have a patient assistance program, so unless you’re rich, you won’t pay more than $75 to $100 out of pocket.

Your doctor has to order it. The test involves a cheek swab that is mailed to the company for analysis.
Tiffany
I stopped taking my Provigil. All the other meds I take cause drowsiness. Hoping after my neck surgery I can try it again. I was only on it for a few days. Dr thinks because of my other meds that is why I am not feeling the full effect.
Karen
vyvanse is not considered first-line for N. but, as for that, as well as for other stims, efficacy will depend largely on your personal chemistry. the one thing i would mention is that effexor will reduce effectiveness of *any* stim, and/or can exacerbate certain N symptoms. personally, unless your C is extraordinarily severe and/or you've exhausted other attempts at controlling your C, i would recommend avoiding effexor. it is notoriously problematic for many people, and is known to cause many side effects, some which can last even after you have stopped taking it. also, it is notoriously physically addictive, so to stop taking it, you must do so only by tapering off slowly, with drs guidance.
Suz
I take med holidays a few days a week (if possible) and it helps control tolerance. That aside, it takes most pwn A WHOLE LOT of trial and error to come up with the right med cocktail that works for that individual patient
Caleb
Agmatine. Magnesium glycinate. Mematine. Huperzine A. Moclobemide & selegiline (latter nasally if used in combo with the former, greatly reduce stimulant dose as well)
Just to clarify, the first 4 are tolerance reducers/blockers and the last 2 are MAO inhibitors which stimulate atypically, while also potentiating stimulants relatively safely if taken as indicated
Dustin
What's weird about me is my adderall used to get me pumped,now it makes me calm,chill,and weird feeling.i also feel like I never sleep when I take it.i DO sleep,eat healthy,let,etc I don't know what's up.adrenal fatigue or maybe it's interfering with my deep sleep?can me being on a low carb diet be effecting it too?
Roxine
Absolutely feel exhausted I also take 60mg of adderall and it doesn't help. I tend to jump all over the place with stimulants hoping to find one that works and I haven't had any luck. I work full time and am a mother to a 9 year old and 11 year old. I often wonder how I'm going to get through the day. Just doesn't make sense that 20mg of adderall helps so many people but it doesn't help me.
Carol
I just felt the exhaustion was delayed... after a little while a week or 2 I thought it was working too well and slept worse. No one ever addressed my poor sleep... just wanted me to stay awake.... I have since found the perfect combination of meds for sleep and sustain my energy through the day with Rhodiolla (don't use if bipolar) and adrenal support ....used a total of 15 mg of Ritalin for the last whole week no more than 10mg per day. Exciting stuff for me if certain doctor people would listen.
Sabrina
I find a drug holiday works well for a little bit, but back to tired again in a few months. I have the same problem which is why I'm not working at the moment. I take adderall xr 20mg 2x/day + 10mg regular adderall each day. I take a scheduled nap each day to get ahead of the crashing. It helps, but like advil helps you after surgery. (Not much help).
Tony
I used to but I started taking L-citrulline malate 4 years ago and I've been able to reduce my adderall from 90mg a day to 7.5 mg only when I drive by agreement with my doctor. Before I started the citrulline, it was like being forced awake, now I feel naturally awake.
tony
I take 15mg extended release two times per day and 10mg of regular 2 times a day of dextroamphetamine. My pharmacy changed generic vendors and I did not think much of it. I was able to take my meds and go lay down and take a nap after the switch. I found some of my older generic meds and tried them and it was like night and day!

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