Dextroamphetamine, day 1

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I took my little 10mg capsule when I woke up at 8 AM, and I felt it kick in during my shower. It’s led to a feeling of clarity and less chaos in my brain. I did a few put-off chores before work, and at work I’m not feeling totally overwhelmed by stuff. I’m still not focusing on what I mean to be working on, though.

Blood pressure is 131/89, heart rate is 65. Slightly elevated from my baseline but definitely nothing to be worried about. My hands are also slightly shakier than usual but not, like, alarmingly so.

This shows some promise and I’ll be working to adjust the dosage and timing accordingly. I might try supplementing with a caffeine microdose later today.

Also, last night was my first dose of fenofibrate, which hasn’t solved all my pain issues overnight but I’d expect that to take a week or so to be effective.

Vyvanse, day 1

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Today was my first day trialing Vyvanse, just a single 10mg dose in the morning. I took it at around 9 AM, and felt it kick in at around 10. It gave me a slight headache, and a slight vague spacy feeling, with maybe a bit of… something that I’m having trouble describing. Almost like my spine was being squeezed from the inside? I don’t know.

My blood pressure and heart rate did rise up a little, but not to concerning levels; my rest pulse is usually 50-60 and my BP is usually 120/80, and on Vyvanse it peaked at around 75 and 135/85, respectively. Nothing terribly concerning, and not so much that I could feel it myself.

I don’t feel like I’m specifically more focused than usual, although my headspace is at least a bit less cluttered. And I’m definitely more alert than usual. It’s not quite how I felt on the two good days of Adderall, but it’s also not like, say, Concerta or Strattera which had me feeling frustrated and, well, colicky, for lack of a better term.1

Anyway. It was good to try this experiment on a day right before a weekend, since that means it won’t mess up the rest of my week if something went wrong, and also this was on a day I wasn’t expecting to be very productive anyway, what with the everything. I’ll be skipping it over the weekend but now I’m feeling a lot more optimistic about resuming it on Monday.

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Armodafinil, day 1

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A few weeks ago I learned about armodafinil as an alternate non-stimulant ADHD treatment; this seemed pretty compelling to me because stimulant-based meds have always been troublesome for me for various reasons.

Unfortunately, it’s only off-label for ADHD; fortunately it’s on-label for a bunch of other conditions I have, and the theory of it working for ADHD is that it treats underlying sleep conditions that make ADHD worse, rather than treating the ADHD itself.

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So much for Wellbutrin

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Yesterday I was feeling pretty off, in a “wow I think my blood pressure is spiking again” way. And I happened to have an appointment at the pain clinic, and they measured my blood pressure at 160/90, which is, you know, Pretty High. At the time I chalked it up to having walked over there in a hurry, but throughout the afternoon and evening I kept measuring it and it remained that high.

And then all night long I had a hell of a time sleeping. I only got around 3 hours of sleep total; most of the time I was just lying awake, blood pounding in my ears, feeling like I was going to die. At 3 AM I also checked my blood pressure again and it was 160/100. Yikes.

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ADHD and fibromyalgia and nortriptyline

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Yesterday I finally met with a new psychiatrist (having lost access to my previous one back in, oh, March), with the intention of figuring out what to try next in terms of ADHD medication.

As a recap, the first medication I tried (Concerta) just made me irritable and gave me tachycardia, and the second one I tried (Adderall) worked really well for my brain but also made my blood pressure skyrocket.

Anyway, on Tuesday I had also met with my pain doc and the decision we came to was that we should try increasing the nortriptyline again, since 20mg is doing something but not enough, and I couldn’t really remember why I felt like 30 was too much. He wants me to target 40-50mg for my eventual long-term dosage.

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The sorry state of medication reminder software

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I use an app called Medisafe to give me my medication reminders. It’s useful because it tracks my doses and also tracks how much I have left so I know when to order refills and so on. I’ve been using it for years.

Unfortunately it has a critical problem in that it only sends three easy-to-miss reminders spaced ten minutes apart with no way of configuring it. So often I’ll end up taking my medication a few hours later than the scheduled time, because I head to bed and notice the pending reminder that I meant to fulfill.

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Balance

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So, in anticipation of my new job starting next week I’m trying to figure out what the right balance of medications should be for my various neurological issues, and I’m not sure where the balance point should be. I’m mostly thinking out loud here, but I am going to try to walk through it and maybe folks with more experience can comment, or something.

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Adderall pluses and minuses

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So, on the plus side, Adderall XR has been helping me quite a lot with my focus and executive functioning.

On the minus side, I’m having several of the unpleasant side effects: greatly increased blood pressure, numb toes, migraines/nausea (starting yesterday or so), and constipation.

I was really hoping I finally found something that works for me. Maybe I should stop taking it for a couple days and see how I feel. Because right now I just feel bad.

First day on Adderall XR

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So after Concerta turned out to be not a great fit for me I stopped taking it, and decided to wait until my next psychiatrist appointment to try something new.

That appointment was on Wednesday, and the psychiatrist decided that Adderall XR (10mg/day) would be the next logical thing to try. The prescription arrived yesterday (Kaiser’s mail-order pharmacy works fast!) and so I took my first dose this morning.

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