Why is Vyvanse so Popular | ADHD | Episode 82

Lisdexamfetamine (Vyvanse) is a pro-drug form of a stimulant that not only works very well for many patients with ADHD, but also was marketed very aggressively.
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[@tomaszfalkowski7508]

My experience with Vyvanse has been relatively positive, I have been taking it for over a year. I was diagnosed with attention deficit disorder, but the non-hyperactive version. I tend to have a low energy drive, which makes me procrastinate and over think, and I have low self-esteem, and I often keep to myself. But when I started taking Vyvanse 40mg, I actually became more energetic, and I no longer procrastinate. I also noticed that my self-esteem improved, and I am more willing to engage in conversations with people. I think it's safe to say that Vyvanse helps me break out of my shell.

[@dr.johnkruse6708]

Thanks for sharing, and I am glad that it has helped.

[@melissasue3328]

this is exactly me and what im hoping to get help with

[@86miles86]

@@melissasue3328any update, Melissa?

[@ilovethatsound-relaxingvid3401]

Thank you for sharing this video, I finally decided at 26 years old to schedule a doctor's appointment to manage my ADHD. When I was 12 I was prescribed this, and I can remember that I did great in school, I stopped failing my classes. Fast-forward to present day, I can't focus on anything in the house without getting overwhelmed, always side tracked, I also have issues remembering directions at my job. I can't stay focused, studying and driving my car are very taxing on my mind. Reading KZbin comments is almost impossible, especially long text. I have a hard time organizing my clothes. Getting out of bed on a normal day is near impossible without an urgent reason to wake up like school or work, I heard that ADD/ADHD can be hereditary, therefore my mother has been on medication for all her life and I feel like it will help me so much again. I am struggling a lot! I even meditate and exercise daily and the issues are still here, I want to manage this professionally with a doctor.

[@dr.johnkruse6708]

I hope that the Vyvanse helps again like it appears to have done a decade and a half ago. Yes, there is a strong genetic component to ADHD.

[@nicksvlogcastchannel361]

You literally covered any questions I could possibly think of regarding Vyvanse. I recently started this medication and became curious to learn more about it because I used to take Adderall and have been pleasantly surprised at how much less anxiety and steady results I get from Vyvanse. I was wondering if this is in my head or if there are scientific reasons for this. Great explanation of all this research you have done. Thank you!

[@dr.johnkruse6708]

You're welcome. If your prescribing doctor didn't provide you with most of this information, it may be useful to let them know about this video, so that they can share it with others as well.

[@yungpm]

I hope you don’t plan on using Vyvanse for the rest of your life. Otherwise you’re in for a world of brain fog and worsening adhd symptoms after quitting. If I could scream at little 14 year old me to never take it, I would.

[@nicksvlogcastchannel361]

@@yungpm I totally hear you it's apparent to me that it's not normal to put stimulants like Vyvanse in your body on a regular basis. Im extremely dedicated, disciplined, and knowledgeable about wellness and there's a lot of things a person can do to counteract that fog after stopping. This past year I usually take it for a few weeks on and a few weeks off. When I finish the two weeks on, I notice 1 to even 4 days of feeling like I'm below my baseline energy and concentration levels but I make it a point to go into those first days after a rest day from exercise, then I do a very hard workout that I push through followed by a long sauna session and an ice bath. This probably sounds insane to some people but I do those things anyways as part of my routine. I just turn it up a notch and do my routine early in the day. I then swing by Starbucks and feel amazing and ready to conquer haha.

[@davidz3460]

⁠​⁠​⁠​⁠@@nicksvlogcastchannel361 I’m 29 and just got diagnosed with pretty bad adhd few days ago, my psychiatrist congratulated me and said i scored the highest out of all his patients in 15 years of his practice lmao. Now, I been doing non stop researching to see if I wanna try adderal or vyvance and can’t make up my mind. Did adderall give you any bad side effects and that’s why you switch to vyvance ?

[@theweirddev]

Thanks for these videos. I find them very informative.

[@charvis71]

Great video

[@AA-cw7ql]

The extended release is nice.

[@jeph9466]

thanks for this video. i'm starting vyvanse tomorrow and this has been very helpful. also, seeing all your responses in the comments have been very helpful too.

[@tflbo]

Thank you for this info. I am hoping to start the new generic vyvanse (partly due to the concerta shortage - I just hope my pharmacy can actually get the generic vyvanse), and I’ve been trying to learn more about it. Feeling optimistic!

[@5050hawaiianstar]

Excellent video, excellent information!!! I so, greatly appreciate you! Please never stop posting, please keep giving this information because you have no idea how much you just told me today and I can only imagine how many other people like me, with ADD/ADHD who can benefit from this knowledge

[@dr.johnkruse6708]

Thanks for the feedback and feel free to share these videos with others.

[@AA-cw7ql]

My Vyvance was 100% covered by my Health Insurance

[@calmbrownie64yt72]

Thanks for this video. Starting this tomorrow. I am ready for the long journey. Much love

[@dr.johnkruse6708]

I hope that it goes well for you.

[@ayohilary7744]

Thanks for this video. I started 10mg of Vyvanse a week ago and it's been a game changer. I can organize my thoughts better at work and I'm more articulate. So far zero side effects. I got about 4 hours of sleep last night and normally I wouldn't be able to function with such little sleep but today on vyvanse I felt fine.

[@dr.johnkruse6708]

I'm glad that it is working for you, and thanks for sharing your experience.

[@Rendani120]

Im taking 40 mg atm. Cant take it too late in the day because then i would have probs going to sleep Also when i decide to not take it for a day or two i fall into a hole

[@sundaymoon000]

Thank you because I just got prescribed today and the light at the end of my tunnel was dimming quickly. Lol

[@harrison1671]

Thank you

[@ralfwashington1502]

Great video and explanation. I have a coworker who is a recovering drug addict with ADHD and they confirmed it burns when you snort it but still will have an effect. Although it's not as nice as Adderall

[@jegerbest89]

Hi Doctor John. Nice video! I have some questions about working out on Vyvanse. I havent dared to let my heart rate get faster since ive been on Vyvanse. Is it safe to jog or run while im on it?

[@therabbithat]

Topic request: I am not curious to try dexoxyn but i am curiois to learn about it, especially as the (deserved?) stigma around it is part of what causes the stigma against completely different amphetamines

[@chiquitabee11]

Awesome information n very helpful. As today is my second day on Vyvanse. Yes, my insurance didn’t cover it and I had to pay $300.00 so, I hope it can be helpful and I can regain myself, my marriage and organize my life once and for all. I’ve always been a neat person but since the past two years without medications, I feel my life has been a roller coaster. How long does it normally take to kick in and how long does the body accept or reject? Is it normal on the first day to be a little jittery ???? Will it hurt better?

[@dr.johnkruse6708]

Most people see benefits from Vyvanse on the first day they take it. If you are just a little jittery, most bodies adjust to that in a few days, but it could also be a sign that the dose is too high. And it shouldn't hurt!

[@rubenproost2552]

Sounds good. Concerta only works properly for 3 hours, dexamphetamine for 1 hour.

[@the2dudes1]

Very informative video. Thank you for this information

[@farhiyaa4880]

Please do a review on dexedrine.

[@sleepnaught9273]

Hi Dr. Kruse, thanks for the super informative video! I have been confused about how Vyvanse can have such a long effective period (up to 14 hours) compared to IR Dexamphetamine (D-amp) when the blood concentration graphs I've seen actually look very similar. See, for instance, the graph in the Pharmacokinetics section of the wiki page on Lisdexamfetamine. There they show the addition of the L-lysine removal step shifts the blood concentration curve of Vyvanse ahead by a little over an hour compared to IR D-amp. Thus peak concentration is achieved an hour later, but otherwise the Vyvanse and IR D-amp curves look the same. From this graph I would have expected Vyvanse to just kick in an hour later and then last the same 6 hours as IR D-amp. Do you know why this isn't the case?

[@sleepnaught9273]

Actually, I have sort of answered my own question by reading the paper that wikipedia graph was sourced from. The paper recorded blood concentrations and subjected effects of Vyvanse and IR D-amp over 24 hours and found basically no difference between the two other than the vyvanse being shifted later by ~ 1h. So their data contradicts the claimed extended (14 hour) effectiveness of Vyvanse. I guess more studies are needed :)

[@dr.johnkruse6708]

@@sleepnaught9273 the graph doesn't seem to be how most bodies actually respond to lisdexamphetamine which is to have a substantially longer half life (and lower peak) because the red blood cells have a limited capacity to cleave off the lysine, so the availability of D-amphetamine isn't just delayed initially, but extended.

[@alannah8891]

This is a great video with tons of great information! I’m curious if there are conditions people may have where their Red blood cells have trouble cleaving off the medication? Or the opposite - making it cleave very fast. I once told my psychiatrist that “Vyvanse was the Gucci of adhd meds” lol 😂 at least in my experience! Thanks again for your videos!

[@dr.johnkruse6708]

I'm glad that this has been helpful. I haven't found any research or clinical reports regarding whether some individuals are particularly fast or slow metabolizers of Vyvanse - I wouldn't be surprised if the manufacturer had data on this.

[@Tenmo8life]

Its like normal Amphetamine, but weaker and without 90% of the side effects

[@eirini98]

It isn't weaker. It has a longer onset of action than IR release amphetamine formulations, is rate limited by hydrolysis by red blood cells, thus providing a tonic release of dopamine, so you don't get that instant "hit" (pulsatile release), which is probably why you consider it weaker. At 130-150mg, LDX showed as much "drug-likability" as IR d-amph. Not advisable to try this though

[@Tenmo8life]

@@eirini98 It is weaker, just do a google search you imbecill.... *30mg of Lisdexamfetamine* converts into about *9mg of dextroamphetamine* when the body seperates the Lysine part of the molecule. do some brain before using your fingers

[@Tenmo8life]

@@eirini98 when bro tryna sound smart, gets educated and now doesnt respond back 💀 Atleast you edited your comment, so that you can take back all them moronic fancy words and nobody could tell ☝️🐵

[@eirini98]

@@Tenmo8life I must have missed something as I've no idea what you're talking about. Who is "bro" and what did he do? If it was in relation to me, I type too quickly 99% of the time, resulting in mistakes and having to go back and make corrections. I hope you're OK though as I only see the two of us here

[@Tenmo8life]

@@eirini98 im talking about Vyvanse vs other amphetamines like dextroamphetamine. You obviously have no clue at all what you are talking about, bro

[@erickfernando18]

Vyvanse worked the best for me 🙌 tried everything under the sun, Ritalin, Concerta, straterra etc

[@Burevestnik9M730]

What was the initial set of symptoms you presented with?

[@kristianalexanderpedersen7382]

does it still do you good one year later?

[@erickfernando18]

I like the info but the Audio from the mic is too low, can barely hear the words, and I have the volume to the max Thanks

[@AA-cw7ql]

This drug helps me with my ADHD

[@guylandgraf6366]

Thanks for sharing your knowledge. Helpful for sure. I’ve been on lisdexamphetamine for 6mons or so. Due to the shortage and back order of this in demand popular generic my dr is having me go to adderall xr 10mg. Is this advisable? And/or what should I expect 🙏🏻

[@dr.johnkruse6708]

Individual results vary, but 30 mg Vyvanse contains roughly the same amount of amphetamine as 10 mg Adderall XR. Many people notice either more abrupt onset or offset when taking Adderall XR. For a few people the effects aren't that different from Vyvanse.

[@yogaexercise9637]

I was just prescribed Vyvanse (but generic) for ME/CFS. My energy is low, but my primary symptom is moderate (on the strong side) brain fog---feeling like my head is full of lead, like the mental energy you'd have if you were quite sick with a flu. The doc said they're seeing benefit with this tx--have you heard of this? I thought maybe I should look at HRT (I'm 68/13 yrs past menopause, on no other meds), but she is opposed because I have microvascular ischemia from brain MRI, but my thinking is that clotting is avoided by any administration other than oral. If you have any response at all to my comment, it would be immensely helpful! Great video, thank you!

[@dr.johnkruse6708]

Yes stimulants are often prescribed (and work in some people) for brain fog. Here is my video on this topic kzbin.info/www/bejne/oWHKm6lna7p4sLc

[@RedOakCrow]

Did the meds enable you to pick up hobbies you dropped when you were younger or give you the focus power you needed to learn new skills?

[@matt.108]

Do you find that lisdexamfetamine has less effects on GI side effects. Particularly compared to how adderall is digested? I plan an switching to lisdexamfetamine as the mixed salts in adderall seem to cause reflux issues. Not sure how you feel about this.I’m just glad I have a lot of valuable information on these medications.

[@dr.johnkruse6708]

Yes, I have had fewer people complain of g.i. issues with Vyvanse than with Adderall products, and I have had people switch from immediate release amphetamine salts to Vyvanse and see improvement. I'm not sure how much of this is due to the slow release formulation, or that the amphetamine is linked to lysine and inactive while in the g.i. tract, or differences between levo and dextro amphetamine and g.i. irritation, or to expectations that things will be better with Vyvanse.

[@matt.108]

@@dr.johnkruse6708 thanks for the reply sir. I’ll give vyvanse a shot next month.

[@matt.108]

Yeah vyvanse is better took it for the first time this morning. But. It only lasts 4 hours.

[@currypablo]

This drug is truly beneficial for those who have ADHD and addictive personalities because it has to be digested before it starts to take effect. You should not get jitters. Just avoid excessive caffeine intake and nicotine so you don't get the shakes 😵‍💫

[@GoADHDGo]

Is Vyvanse popular? I guess I should know that it is because every time I submit my Vyvanse refill request I get a “out of stock” message from my pharmacist. Every. Single. Time. Vyvanse has been the most effective ADHD medication for me. I can’t take a whole capsule, though, because if I do it makes me anxious. Therefore, I “split” my dosage. I made a whole video about it. Basically I take half in the morning and half a few hours later. It works incredibly well for me.

[@dr.johnkruse6708]

That's a schedule that has also worked for a few of my patients.

[@tinaquattrocchi75]

What mg are you on?

[@GoADHDGo]

@@tinaquattrocchi75 70mg.

[@matt.108]

@@GoADHDGo that might be why. That’s a pretty high dose. Have you tried taking a 2 week break from it and starting with 30-40mg?

[@kellycooper8971]

Me too! I just have half. People feel anxious cause they have to much

[@GamerOctopus]

5:16 This is the first time I’ve found information on the internet about how Vyvanse works to slowly release dextroamphetamine in the system. Pharmacology is one of my “special interests” and I have spent years studying psychostimulants & addiction through both professional literature & anecdotal reports online. I always understood that the lysine molecule has to be eliminated from the prodrug in order for lisdexamfetamine to become biologically active through the process of hydrolysis, but I never understood why it never hit all at once & consequently had a slow release. From what I can gather, you’re saying that the rate at which the lysine is removed is not all at once? It’s a slow process? My confusion was always that I thought this was a very quick process in which the lysine is immediately removed upon ingestion in a process that takes about 30-60 minutes… and then another another 15-30 minutes for the dextroamphetamine to kick in once the lysine has been removed. Anyway I’m not a doctor but I have always found this fascinating. It sounds very complex & interesting to me. I feel like we can never really know for sure with 100% accuracy, but expanding knowledge never hurts. Thank you for sharing doc! Also glad to tell you that I have successfully gotten off of amphetamines & have found other ways to cope with my ADHD. I feel like these meds should be used only in complex cases of ADHD. I took Vyvanse for several months around age 19 to help me stop abusing marijuana, alcohol & psychedelics. It really helped me a lot but my use ended when I was hospitalized for amphetamine induced psychosis. After a few months of antipsychotic treatment, deep reflection into myself, a couple mushroom trips, & return to occasional marijuana use, I feel that I am finally back to normal & can use substances sparingly in a healthy way & not rely on them like I used to. Obviously this was a lot to process, as psychosis & substance addiction is no joke, but be warned that although Vyvanse has less potential for abuse… it is still VERY addictive & can cause SERIOUS problems, even for people who genuinely “need” it. P.S. I hope sharing my story helped some people out. It is a shame that marijuana & psychedelics are still illegal in many places & yet doctors continue to profit off addictive pills. Many mental health professionals are clueless and can’t keep up with several patients at a time. They have a financial motivation to keep you in the system & it’s hard for them to understand that you don’t want to be medicated forever. Being reliant on pills & therapists is almost as destructive as using weed & psychedelics to cope. Just remember that not everyone in this field genuinely cares about you. Some are straight up lying, but they do genuinely feel as though they are doing the right thing. Prescription drugs worked well for me but also ruined about 1.5 years of my life. I hate that I’m viewed as a criminal & risk jail time for using weed, but those pills were genuinely KILLING me & my doctor was only fueling my addiction & encouraging me to use more… meanwhile reaping financial benefits. It’s messed up that some of us can barely make it paycheck to paycheck & when we get medicated, our docs are buying nice houses & BMWs. In the Bible… they say “money is the root of all evil,” and I feel like this statement has truly aged well. Wishing peace & love for everyone. YOU WILL GET THERE. DO THE FUCKING WORK.

[@dr.johnkruse6708]

Thank you for sharing your experiences, I hope that they can help others. Regarding the speed at which lysine is removed from dextroamphetamine, the point I am making is that the capacity of the system can be at least as important as the speed of the transaction. If you are in the grocery store in the "10 items or less" lane, each person may get through quickly, but if there are fifteen people waiting in line, because they only have on register open, then it will take a long time to process everyone in line. Similarly, the lysine itself is cleaved off quickly in a simple enzymatic reaction, but the availability of these enzymes on the red blood cells is limited (not even registers open).

[@thesunnyroad]

Emm, this is one of my special Interests as well 😎 can we be online friends and info dump each other 😃😀😃😃

[@AA-cw7ql]

Smooth drug

[@MyllerSWE]

Crazy prices in the states.

[@dr.johnkruse6708]

Yes, but the availability of the generic form starting in September 2023 has made this much more affordable to many people.

[@standown7738]

Hey doc. Do u know if there is a generic version of vyvanse here in 2024 and what the cost is of the generic? And also what is the cost of generic dextroamphetamine now in 2024? Thankyou so much. Last question, did u say that the levoampmetamine is better for those that have a hard time paying attention to things, like focusing on matters at hand? Im not hyper, I just can tune out the random nonsense in my head and focus like reading a book and paying attention in class.

[@dr.johnkruse6708]

Generic versions of Vyvanse have been available in the US since late August 2023, and for many people are considerably cheaper. I frequently use goodrx.com to find the costs of medications in any zip code in the US - they will compare what different pharmacies in your area are charging, and for many products have downloadable coupons. But they may sell medical information you input to other entities. Some researchers and pharmaecutical company reps promote the idea that many people note significant differences between dextroamphetamine and levoamphetamine, but clinically I find it hard to make global claims for one over the other. Your own comparisons are the best measures of how it will help you.

[@jackchop1576]

I take it and it's milder and works more in the background than Adderall and Dexedrine. There's no crash unlike with Adderall and doctors feel more comfortable rxing this vs Dexedrine.

[@kevinjames660]

Can you recommend/link literature references looking at safety of long term Vyvanse therapy?

[@dr.johnkruse6708]

Following patients over time is expensive, and drug companies that already have an approved product don't have much incentive to spend their money doing such research. The longest study I have found is just a two year study : www.ncbi.nlm.nih.gov/pmc/articles/PMC5511319/

[@hollymonger7576]

I've been taking adderall xr 20 mg for over 20 years and recently had to switch to vyvanse cause of the adderall shortage. No pharmacies have adderall in my area currently anymore. When speaking with my doctor she said she would put me on the "higher" dose cause she felt that I could handle it. But when I went to pick it up it was only 20mg. Can you think of a reason as to why she may have choose this dose? Especially considering that it takes more vyvanse to get the same response. I will be switching to a new doctor in March as she hasn't been the easiest to work with as my precious doctor who retired last year

[@dr.johnkruse6708]

It's hard to know what someone else is thinking in such a situation. It could be a simple as an error with an electronic prescribing system, where the 20 mg was carried over from the previous prescription. It may be helpful to remind the doctor that only about 1/3 of the mg in Vyvane is actually amphetamine.

[@hollymonger7576]

@Dr. John Kruse Thank you for your reply! I switched to a new doctor and she immediately switched me to 40mg Vyvanse which has been working well. She said that I could honestly jump to 50mg cause that would've been the correct conversion. But I'm good with 40 cause I've always wanted to be on 15mg adderall xr. It just has never been easy to consistently get in my area as 20mg.

[@dr.johnkruse6708]

@@hollymonger7576 I'm glad that you persevered and found a doctor who works well with you.

[@PieRow]

15:06 32% of the US stimulant market, I assume this is pharmaceutical stimulate drugs and does not include caffeine, correct?

[@dr.johnkruse6708]

Yes.

[@michelleneufeld3695]

That was a lot of information that went way over my head. I read that vyvanse is not good for weight loss. What happens if you do lose a lot of weight on it when taking it for adhd and binge eating disorder? What draws the line in the sand when it is safe and when it is not for your heart?

[@kellharris2491]

The reason why some people lose weight on adderall and vyvanse is because it can lower your appetite. But it's not a 'weight lose' medicine. It's more an unintended side effect.

[@astenfe]

is it possible that an cyp2d6 inhibit medication (like a SSRI like Prozac) will increase the level of dextromamphetamine released by Vyvanse?

[@dr.johnkruse6708]

A 2D6 inhibitor may mean that dextroamphetamine is broken down more slowly, so that it is available longer, but it won't change how much is "released". For most individuals, the ability of the red blood cells to cleave the lysine from the dextroamphetamine will have a much bigger impact on level in your blood than whatever is going on with 2D6 activity.

[@eXtremeFX2010]

Nope, not for us... my Kid had a Seizure after taking it for about a month. He was age 7. He has a low Seizure threshold so can't take it. The Seizures were terrifying for a parent to see.😢

[@dr.johnkruse6708]

That certainly sounds very scary. I hope that he is in the majority of people for whom they are just a passing event. Many medications, including all of the stimulants (and Wellbutrin) have the potential to at least slightly lower the seizure threshold.

[@fuosdi64]

Because it's the most expensive one that stuff companies can profit off of

[@Jimmy-vn9hv]

I am 54, I have been diagnosed with anxiety disorder and given benzos in the past. I have used meth on and off for the past 20 years. I called it "clarity". I stopped the meth and was recently diagnosed with ADHD, with the psychiatrist saying I'm a textbook case. Now ive been given a couple ssri meds, but cannot find anyone who will prescribe Vyvanse! Its so frustrating to know there's something out there to help but nobody will prescribe it. I cannot go back to meth its too strong. Grrrrr what's the reason for this dilemma?

[@dr.johnkruse6708]

Our entire medical system has problems, our mental health system is troubled, and ADHD treatment has multiple problems. We have research showing that Vyvanse actually helps those with meth problems to stay abstinent. I hope that you can persist and find someone who will work with you to find what is effective for you and doesn't cause additional problems.

[@katherineswart474]

Hi there, I was diagnosed late in life, (59). have been taking methylphenidate SR 20mg twice daily. What would be the equivalent dose in Vyvanse, if I can ask? I mostly use it. for my working day. Still figuring out which med would be best now I have the diagnosis.

[@katherineswart474]

sorry should have specified-ritalin SR

[@dr.johnkruse6708]

@@katherineswart474 - this is for general informational purposes only, and not a medical recommendation. For most people amphetamine is about twice as strong as methylphenidate, suggesting that 40 mg of long acting methylphenidate might be roughly equivalent to 20 mg amphetamine. A 60 mg dose of Vyvanse contains about 20 mg amphetamine (the bulk of the Vyvanse being the amino acid lysine). Usually people start below their expected target dose, and titrate upwards, rather than starting too high.

[@katherineswart474]

@@dr.johnkruse6708 thanks, that's helpful!

[@ishtarbabylon4869]

I’m going through my dex like crazy .. it’s not lasting long and I end up taking too many . This is my second repeat and I have almost finished one of the bottles of 100 in 3 days! I think I’ve had 50 already😢 I have emailed my Psychiatrist asking him to change my script to Vyvanse once my script runs out

[@dr.johnkruse6708]

Yes, it sounds like it would be important to be in touch with your prescriber. We don't want anything to go off the rails.

[@ishtarbabylon4869]

Ok my doctor changed me to 50mg of Vvyvanse a day .. To be honest I feel like my productivity levels have dropped a bit .. It’s been 5 days .. Maybe I need I higher dose? My Dr said he can’t put me up to 70mg yet legally .. not until this prescription repeats run out .. I’ve emailed him to let him know all this .. I haven’t gotten a response yet as he’s due to go to India so that’s probably why

[@dr.johnkruse6708]

@@ishtarbabylon4869 I'm not aware of laws in any state restricting dosage. A doctor is allowed to write a prescription for the dosage she or he thinks is medically appropriate and safe for treating a condition. And even 70 mg Vyvanse (the largest dose manufactured) contains less amphetamine than a 30 mg dose of Adderall, so there are internal inconsistencies in the FDA recommended doses for various stimulants.

[@ishtarbabylon4869]

@@dr.johnkruse6708 I’m in Australia btw and to be honest I’m grateful that my meds are on PBS My Vvyvanse only cost me $7:30! Because I’m unemployed.. full cost is $98:80! I got a bunch of laundry done after taking my daughter to her swimming lessons but I had 50mgs plus half a capsule of the powder under my tongue .. I don’t feel so hyper but levelled out .. I will ask to be put on the highest dose once script runs out in December

[@blueygooey8899]

Ok so I've been trying to find info on how Vyvanse gets such a constant delivery method and I keep hearing about the limited speed for which the protein is cleaved from the molecule, but I don't understand some of the more fundamental things here Like I've been given metaphors and all sorts to help me understand one goes through at a time. But this information only makes sense to me if the Vyvanse goes straight for the brain, where upon arrival is dutifully organized single file. But that doesn't make sense, that can't be right. The Vyvanse isn't sentient, it doesn't bee line for the brain; so there wouldn't be a pool awaiting entry. A guess I have is that as it is metabolized, red blood cells will take the molecule and protein TO the brain, upon which only one cell can drop off at a time, THEN cleave the two, allowing for a chance arrival single file line?? I'm sorry I really don't get it Does the Vyvanse flood the circulatory system, and whenever a red blood cell sees it by the brain it "opens the door"(so to speak) for one?? I really don't think I'm right but none of what I've seen or can fathom seems to make sense. And I can't fully feel I understand this if I don't have that much Response very much appreciated 🙏

[@dr.johnkruse6708]

Vyvanse in absorbed from your digestive system and floats around in your blood. The heart serves as a pretty good pumping/mixing system so pretty quickly that inactive Vyvanse is evenly distributed throughout your blood. Inactive Vyanse in the vicinity of a red blood cell will be cleaved by an enzyme on/in that red blood to produce active L-amphetamine, and the amino acid lysine. But the amount and efficiency of this particular enzyme is fairly low. So for the first several hours there will be measurable amounts of both inactive Vyvanse that is still uncleaved, and L-amphetamine (and lysine) floating around at the same time. When blood containing L-amphetamine passes by certain dopamine (DA) and norepinephrine (NE) neurons in the brain, it will bind to and act on those cells, causing both release of DA & NE, as well as preventing (temporarily) reuptake of both neurochemicals, so they have longer to act on post-synaptic neurons. Most of the L-amphetamine that is floating around in the blood in other organs is inactive at those sites because the cells there don't have receptors that interact with the L-amphetamine. Just like when you take an antibiotic for a infected tooth, the antibiotic is floating around in your blood in every organ and blood vessel, but unless it is interacting with the bacteria in/around your tooth, it is inactive, because it doesn't have a target that responds to it. I hope this helps, but if there are more questions, fire away!

[@therabbithat]

Blood is constantly flowing through your whole brain, so when your blood has X, your brain has X too (unless something is too big to get through the blood-brain barrier, which is a filter, not a barrier). The medicine doesn't get sent to a specific place, it goes everywhere your blood goes

[@stephzinsmeister662]

Where’s all the information about all of the addiction problems and programs related to these drugs

[@dr.johnkruse6708]

I've addressed addiction and psychosis in other videos on KZbin. Addiction centers advertise all over the internet and are easy to find.

[@brandonriggs6]

My phyciatrist said highest dose he can prescribe me on adderall is 30 mg. Personally i have a high tolerance. Im in texas, is this limit he has due to him personally and his practice? Also would i be able to be given higher doses at a different telehealth phyciatrist? Or is that a state rule?

[@dr.johnkruse6708]

Texas has been making it up its own health rules in other areas to make the politicians, rather than patients happy, but I am not aware of any state having a legal limit on a medication dose. Higher doses might make medical boards or other entities investigate, but a doctor is generally allowed to prescribe a dose that she or he feels is medically appropriate because it is providing benefits without causing adverse effects or the risk of significant adverse effects.

[@sonneko6379]

I'm in michigan I get a double 20mg dose I take in the morning. So I get a 60 count adderall XR 20mg per month.

[@sepidehahmadkhani5516]

What can I have to do when I develop tolerance with my 30 Vyvanse in 3-4 days after starting it? Should I increase or decrease dosage? What I mean by tolerance is that I can't concentrate on my work anymore and my sever procrastination come back and I can't stop it. After few days that vyvans is so good and calming for me, stop working and I call my doctor. He changed my medicine to buprupion and modafinil so they have no good effect and I am surprisingly all day sleepy and sleep more. Then My doctor said I have to increase my vyvans from 30 to 60. I'm a little afraid to double my dosage because of my previous early tolerance (I don't know is it really a tolerance!? ) to Vyvance. If I get used to 60 dosage again soon and can't find another suitable drug, my serious problems in life will continue.

[@dr.johnkruse6708]

Since I don't have a doctor patient relationship with you, I will try to provide some information that might be generically helpful. The first is that it is extremely common in the first few days or weeks to become tolerant to an initial dose. But most often a dose that is working well for you a few weeks or months into treatment is most likely to continue to be effective a year or more later. Many people also experience a "honeymoon" period where their very best response ever to a stimulant is in the first week or two. (I have a video here on the topic.) Vyvanse comes in a broad range of doses, so most often I would increase more gradually, rather than jumping from 30 to 60 right away, especially if someone responded positively to 30 mg.

[@sepidehahmadkhani5516]

@@dr.johnkruse6708 thank you so much for reply🙏🌻

[@Burevestnik9M730]

How does this drug affect the following circuits: cortical striatal striatal-limbic frontostriatal striatopallidum pallidal thalamic? Are there any improvements with athymhormia using this drug? Apathy? Hypobulia? Lack of initiative? Lack of interest?

[@annsan1722]

I can‘t tell you anything about the science stuff behind it, just from my experience. Before taking Vyvanse XR (and knowing about my AD(H)D) I was known as the usually quiet relaxed type as an adult. At home though, I was mostly exhausted, inert, couldn‘t get things done and procrastinated. This definitely chanched with my Meds. Now I can do my important chores in 2 hours and still have mental and bodily energy after that; before I needed the whole weekend to maybe get the same done and felt exhausted. Looking back I know now, that I was suffering from inertia due to my ADD, it’s not about motivation. And now I also know how other people are able to deal with all the things life is asking of you and still have energy to enjoy an active private life.

[@gustiable]

i don’t know but adderall sometimes makes me slightly euphoric 😅

[@dr.johnkruse6708]

It certainly has mood elevating effects in many people.

[@Mbappe_fan300]

I was complaining how worn out I get with my wife and step son both having adhd and how I struggle with there symptoms. Guess what I got diagnosed yesterday I am kind of shocked. I tried vyvanse today 30mg at 3am as I start my day then. I had great results however wore of fast and I got the crash. Is there a short acting version to get me through the rest of the day?

[@dr.johnkruse6708]

There are some people who supplement Vyvanse with immediate release (IR) Adderall. But in general, the IR forms not only go in faster, but leave faster, so they are more likely to cause a crash when they do eventually wear off. With Vyvanse many people expierence a longer duration of action as the dosage increases, so attempting that cautiously might be a reasonable course of action.

[@Mbappe_fan300]

@@dr.johnkruse6708 thanks dude

[@VitorTeixeira.]

I take a 50 mg. pill usually at 06:00h (if I wake up early to go to the bathroom, say 04:00h, I take it at that hour. At around 12:00h I’m beginning to fill the crash, so I take another two 50 mg. pills. I think that’s not probably the best way of dealing with it. So currently my media per day is 150 mg., which I think it’s a lot. Any comments out there about what route should I take? (I’ve also used Ritalin in the past, but formed the habit to crush them and sometimes I was doing 300 mg. a day of it). It goes without saying that I’m an addict and have had issues in the past with substance abuse (crack cocaine). Should I be worried about this amount per day?

[@dr.johnkruse6708]

I would focus more on the effect rather than on how many milligrams. If you are noticing or seeking a boost in mood/pleasure, that would be worrisome, particularly with the history of addiction. There are studies that suggest that Vyvanse can be used safely and helpfully for those who have had addictions to street stimulants.

[@VitorTeixeira.]

@@dr.johnkruse6708 Thank you for the insight. That's what i thought.

[@harstar12345]

Made a video about a drug that you can only watch if you've already started it or do not need it 😅

[@Tabu11211]

I've always preferred Vyvanse over dexedrine. It feels cleaner or something to me. Just wish I could get a sleeping pill now lmfao. I don't want to smoke weed anymore :/

[@dr.johnkruse6708]

I have a video in this channel about some sleeping medications, kzbin.info/www/bejne/rp2ciKuQiJV9ers as well as discussions of some tips for help falling asleep with ADHD kzbin.info/www/bejne/iKfQaWmOrcyEqpY

[@Tam-yg7pk]

Best thing is you only need to remember to take it once per day. Second best thing is it stops the I’m bored snacking. Ohh and I get actual things done now :)

[@dr.johnkruse6708]

I'm glad that it is helping you.

[@Rezzeh]

I started Elvanse (Vyvanse) on 30mg. I hade subtle positive effects especially with being more alert and less procrastination and cravings while working on the computer . But I felt it is not enough somehow like forgetfulness, reading without repeating sentences many times, little mistakes while working, I feel I‘m working the same but with less procrastination. The doctor the put me on 50 mg . Now I feel the before positive effect more than before but still what did not improve on 30mg also did not improve on 50mg. Also, I started to have more issues with forgetting the right words while speaking and mixing words up. Also I feel it is too much like shortness of breath and a little pain in the chest. This started on the 3rd day I took the 50mg m. I think I should stop. I am confused are these the only benefits I can get and maybe this is my limit cognitively or there could be a better medication for me?

[@dr.johnkruse6708]

Almost nobody has complete eradication of ADHD symptoms from any medication or combination of medications. I would try to write a good description (not necessarily lengthy) of how you feel/perform on 0, 30 and 50 mg Vyvanse so you have that for reference. If you have side effects that are unpleasant, and particularly if they are not decreasing, then in usually makes sense to back down on the dose. It would probably be good to compare an amphetamine based product like the Elvanse to a methylphenidate (Ritalin, Concerta) like product so you can see how it works for you. Often an agent like guanfacine would be added to the Elvanse, to see if that provides any additional benefits.

[@oompa420]

why are people addicted to the vivance tho?

[@littleboybluehiphop]

I've been on Adderall 30 mg for 10 years. Switching to Vyvanse this week. Should I?

[@dr.johnkruse6708]

That depends a lot on how well Adderall is working for you. The majority of patients I have worked with who have tried both medications strongly preferred Vyvanse, but individual results can vary.

[@littleboybluehiphop]

@@dr.johnkruse6708 Thank you Dr. kruse

[@ZomBeeNature]

I am severely depressed and can recognize it in others. You seem very depressed. I hope you have done something about it. I just started 20mg Vyvanse today to try to give me more energy. I will see if it works. 😐

[@dr.johnkruse6708]

I appreciate your concern but I don't feel particularly sad, irritable or detached, remain engaged with my work and family, have energy to go running and hiking, and have a good appetite and sleep pretty well. I'm aware that I have a midwest monotone and a rather dry sense of humor, which can contribute to misinterpretations.

[@Leocardion1]

It’s finally available in generic.

[@dr.johnkruse6708]

Yes, last week of August 2023 in the US. I am not anticipating big problems with the generics (but we will see). Most of the problems with generic stimulants have had more to do with differences in the rates of delivery of the drug. With Vyvanse the rate limiting step is how quickly the red blood cell enzyme cuts the dextroamphetamine from the lysine, so it should be harder to mess that up.

[@tylerbennett803]

I'm about to start this medication and suffer from sever sleep apnea and insomnia. Will this medication increase insomnia even if I take early in the day. Anyone else have this experience?

[@dr.johnkruse6708]

I've seen it worsen insomnia in some people, and improve it in others. Taking it at a consistent time and early in the morning tends to help stabilize circadian rhythms and possibly leads to expending more energy during the day, so the more common response is for an improvement in sleep.

[@sundaymoon000]

Where can I get coupons for this please?

[@dr.johnkruse6708]

THe company that makes it offers discounts here: www.vyvanse.com/coupon?TAK%7CVyvanse%7CADHD%7CDTC%7C%7C%7CVyvanse+-+Brand+-+Coupon&+patient+assistance_sitelink&C2%AE%20savings%20offer&showmg=true&gclid=Cj0KCQiA54KfBhCKARIsAJzSrdqYsbmv5hqf6DJNA2WOqt4vmLudvWkoCzsszB6PEZKCWg1QektAVwYaApWpEALw_wcB&gclsrc=aw.ds goodrx.com also has coupons on their website.

[@lisapuma1983]

Good rx

[@chrisharder1870]

I need to pass this test that my dr gave me a year ago to take… and I told her that I probably won’t sit down and read it or answer the questions and I can’t get out of bed or clean or get a job… I use meth every day… and I need adderral stimulants to function but I need help reading and answering the test questions she gave me a year ago… please reply or video call me… I am imberrasd to write this and ask for help… but please help

[@dr.johnkruse6708]

Maybe setting aside 10-20 minutes each day to try to answer just one question will help you get through the list of questions. Or have a friend or family member sit with you to try to work on the questions. Or even someone from an ADHD support group like CHADD may be able to help you understand and address each question. There are a few studies showing vyvanse can help people let go of their meth addictions.

[@chrisharder1870]

@@dr.johnkruse6708 thank you…. I’m look into CHAD

[@behindyou3689]

can you get this without a prescription?

[@dr.johnkruse6708]

In the US Vyvanse is a prescription only medication. Most other countries also consider a controlled substance, requiring a prescripton.

[@behindyou3689]

@@dr.johnkruse6708 odd questions but I am unable to go to the doctor and get a prescription. Are there any drugs or supplements or chemical compounds or anything that may work similarly to amphetamines or Vyvanse that I can get without a prescription. I have tried DMAA but it's just not as good.

[@missvida6251]

Hey Doc, did you take any Vyvanse prior to making this video?

[@dr.johnkruse6708]

Nope.

[@khaoticgrumpy]

So popular because it feels exactly like meth, even though it’s converted to dextroamphetamine, it doesn’t feel like ir dextroamphetamine(Dexedrine), maybe the slow release side effects less noticeable which make it feel more like meth but idk.

[@dr.johnkruse6708]

You're the first person I've heard say that it feels exactly like meth; most people describe Vyvanse as "smooth", something I almost never hear with meth. kzbin.info/www/bejne/aJichneVh552ZqM

[@khaoticgrumpy]

@@dr.johnkruse6708 yes, that what I mean by that, an oral dose of meth has little side effects/feels a lot smoother, maybe I metabolize vyvanse too quickly because it states 8-16hr duration but after 4 hours I get sleepy, groggy, less sharp one might say. My current dose is 40mg and Ik it’s once a day but I find take half when I. Wake up and other half when I feel it wearing off,4-5 hrs I take the other half, at least it isn’t as neurotoxic as meth(dopamine toxic). I have heard news of a recent rehab using vyvanse as a detox drugs for meth withdrawal and read it went really well. Last note: the video u linked is adderall vs meth, adderall is 3:1 d to l amphetamine, adderall deff doesn’t feel as close to meth as vyvanse, even pure Dexedrine feels different than meth, I think the slow release of d amphetamine in the blood that lowers side effects and makes it feel “smother” is y I feel it’s the closet drug i’ve tried that’s most similar to meth(orally), smoking/snorting deff a lot more “euphoric, fidgety, etc. pls look up “vyvanse feels like meth, Reddit” and you’ll come across similar accounts. I’m probably just a minority but I’m glad it helps my add and also opioid use disorder. Ik exercise releases natural endorphins but feel like d amphetamine somehow effects natural endorphins too

[@madeleinehuhtalo]

I have been eating elvanse for 12 years, and it was among the biggest mistakes I made. I've had dyslexia from it, memory problems, I've almost become an emu despite taking 80mg, it takes three to four hours before I get a tiny bit of an effect. still jan I do not wake up in the head until I take it, but after a long time. I've tried to quit, but I'm in a worse state now than BEFORE I started. elvanse has hurt me over the years, and it gives lots of side effects after many years that damage both brain and body. I can't think straight whether with or without now. and this crap drug like elvanse should be banned. YES! you feel good for the first 7 years, but then the damage occurs in both brain and body. if you can fix another treatment, that's good

[@dr.johnkruse6708]

I'm sorry to hear that you've had such a terrible experience. There are many with ADHD in the US who continue to have benefit from Vyvanse over many years.

[@ralfwashington1502]

I'm on 20mg and feel a bit spacy and slightly less connected to my emotions. My ADHD symptoms are better though. Almost feels like CBD oil but without feeling super relaxed. Anyone else notice this?

[@Burevestnik9M730]

Which particular CBD oil do you recommend?

[@ralfwashington1502]

@@Burevestnik9M730 I just did a search on good CBD brands and tried Mediterra (something like that) it's got a purple and silver design around the bottle. Although I heard full spectrum is better so if I buy again id find something full spectrum. Although I know from experience Mediterra does work and is not snake oil. Btw I recommend buying a higher strength since you need less to get an effect. It is more expensive but lasts longer.

[@oompa420]

when u take low doses u feel like this but i took 100mg once and felt like i was on meth

[@therabbithat]

@@oompa420 60 is the usual max dose with 70 for people who 60 doesn't work for. You accidentally double dosed? That must have been pure hell. Did it last like 40 hours?

[@scoobyscousin2922]

​@@oompa420lmao damn

[@mackknife8414]

I still feel tired after 30mg of vyvanse

[@currypablo]

May need to increase your dosage or switch to a fast release ADHD medication 💊

[@thetonybones]

Play at 1.25x, you’re welcome.

[@dr.johnkruse6708]

Great!

[@gustiable]

i just changed from adderall to vyvanse and i just want to say that i am in favor of medication that is less likely to be misused

[@yungpm]

Vyvanse ruined my life. Gave me brainfog and made my adhd worse.

[@dr.johnkruse6708]

I'm sorry it made things worse, but I appreciate your willingness to share your experience here.

[@josecarlosrodriguez3946]

What happened? How much did you take per day?

[@noelelanderniiva1859]

Great video but Are u good? U seem a bit sad

[@dr.johnkruse6708]

Thanks for asking. I thoroughly enjoy my work and family and friends but I don't have the most dynamic or enthusiastic demeanor. I don't recall anything particularly problematic six months ago when this was filmed.

[@stevenbest6923]

I’m sorry I fell sleep, where were we??

[@manomemano7402]

Haha I always fall asleep on Ritalin. This dude is equal to Ritalin. I already feel the dopamine.

[@jw7665]

@@manomemano7402 1.5x or even 2x the video speed is your friend lol. His information is great, though.

[@jackchop1576]

He just needs to up his Vyvanse dosage.

[@anthonyrez7000]

Bro im dead

[@chrisharder1870]

Lol

[@Th33CouchPros]

Good info but bonestly please work on your presentation

[@dr.johnkruse6708]

I'm happy to. In your opinion, what aspects of the presentation need work?

[@BigIndianBindi-jy1cz]

there's lysine in beans. doesn't have to be animal sources

[@Yosetime]

I'm one minute in and bored already. Waiting for him to speak faster. I could speed up the playback speed and hope it's worth it. So very mono-tone and I'm uncertain what the video is even about. I'll try. If this doc is trying to grow an audience he has a great deal of presentation skills to learn.

[@jcmangan]

I can`t aswer this question. It`s lousier than immedeate release amphetamine in almost any way.

[@AA-cw7ql]

Withdrawyl is awful!

[@user-nm6xn8yg5k]

Fix your lighting & speak louder ❤

[@leewilliams2310]

This man is so flat.

[@dr.johnkruse6708]

He's there to provide information, not entertainment. And if you listen closely, there's entertainment too.

[@Rebelgs1]

Doc is having Vyvanse end of day crash I guess 😢

[@JRR100]

What good are emotions? Clearly this guy would not know!

[@dr.johnkruse6708]

Please don't speak about that which you don't know.

[@mackknife8414]

Is he just reading shit or what

[@dr.johnkruse6708]

No, I'm sharing my thoughts after extensive research and attentive listening to what people with ADHD have reported to me.

[@mrorange3490]

Does it cause psychosis like adderall does?

[@dr.johnkruse6708]

It certainly has the potential for psychosis.

[@mrorange3490]

This is what I am worried about most. Was asking for someone in my family who ALWAYS would have psychosis when they would take adderall. They had stopped taking it for the past year but then they started taking vyvanse a few days ago instead, so I’m really worried that they will start having auditory/tactile hallucinations again and paranoid delusions, etc. they have young children too, and now that I live about 1h30 away, I can’t be there to help them as much as before when they lived only 1 minute away. I’m hoping that vyvanse is less likely to cause psychosis. That person was diagnosed as having bipolar disorder on 3 separate occasions and I read that will increase the potential for psychosis? Someone had suggested once that she had bipolar disorder with psychotic features and that her psychotic episodes were a result of that condition and that it was only a, “coincidence,” that she was having essentially schizophrenic like symptoms When she takes adderall. She ONLY has those symptoms when she is on adderall. I have known Her for 12 years and she only has psychosis whn she takes adderall. Now that she is on vyvanse I’m afraid it may have the same effect as adderall. I hope not

[@dr.johnkruse6708]

@@mrorange3490 I hope not as well. But I would not feel the least bit prescribing any form of amphetamine in the situation you described. Contrary to what some people think, someone can take a stimulant for weeks or even years before developing a psychotic reaction. The very fist case I saw was someone who had (an undisclosed) psychotic reaction to street meth a decade previously. They did well on Adderall, were able to finally complete their college degree in their 40's, and then more than a year and a half later developed a full blown psychotic episode on the Adderall.

[@mrorange3490]

@@dr.johnkruse6708 thank you. I don’t know what else I can do at this point because she is in denial about the cause of her previous psychotic episodes. Essentially she would say that her psychosis was caused by her husband “stressing her out and abusing her,” which was a lie. She basically said that her psychosis was being caused by “ptsd,” from her husband and ironically, when she was taking the adderall, she was the one being abusive, not him. She tells so many lies that it’s hard to tell if she actually believes what she tells people. She is already manic after taking vyvanse for a week. Next will come the psychosis I’m sure. Not sure what to do next because she will get angry with me infinity to help her. She is abusing the medication because she doesn’t even have ADHD so it has the opposite effect on her

[@mrorange3490]

What if you just take too much of it?

[@dr.johnkruse6708]

You can certainly take too much of any stimulant, and depending on the dose you'll get agitation, hypertension, cardiac arrhythmias, seizures, and if high enough hyperthermia and death. Because the capacity of your red blood cells to cleave dextroamphetamine from lysine is limited, this at least delays and decreases the likelihood of getting too high a dose with Vyvanse.