Audio format coming out this fall, if all things come together as I expect. I think Dr. Parker is one of the most rational doctors I’ve known save my own, and one would be well to heed his advice. So I am only writing from the theory/assumption/viewpoint that the person truly is Bipolar and responding well to mood stabilzers, but also is AD(H)D. Lorre, You’re demonstrating the phenomenon of a narrow therapeutic window, and clear metabolic slowing through one of a number of pathways. It has been 10 days since I sent the first email about my brother and our fear that the 70 mg dose of Vyvanse was causing severe restlessness, tremors and insomnia.

Im 15 years old and i takeing 40 mg of vyvanse. 3. crying spells, these side effects were worst, vs. when he wasn’t on medication.

I have been on Ritalin, 5 mg every 4 hrs (great grades, got into a great university, but Ritalin made me increasingly anxious (on ANY dose) then Stattera (did nothing) than DL-amphetamin (a comparable low dose, just as the ritalin) which was fine for work, but increased my anxiety and made me lethargic with a tendency for procastination in the long run. So no person can make a statement that “diabetes is not downstream from Vyvanse.”. Hasty reply but hopefully helpful:

Hello Dr. Parker, i realize this a very old thread but I hope you get to see my post. Fran V. Fran, For these folks only someone completely comfortable with those higher [notice I didn’t say ‘highest’] doses of medications [using the predictable, careful titration strategies outlined in multiple posts here at CorePsychBlog and at is recommended. Seven easy Tips to Recognize the Top of the Therapeutic Window apply here: 1. As to the forgetfulness, inability to come up with words, and switching words in a sentence, I attributed it to my ADD & brain injury. Then I was moved to a combo of Vyvanse and Citalopram. I trust her, but I don’t really understand why! You are a considerate man and the type of insightful and understanding physician so few are these days. My possible contribution to this conundrum is a mix of common sense and experience over the time that Vyvanse has been out – with a dose of clear science about the CYP 450 genetic polymorphisms of 2D6 [see the many posts here – just type 2D6 into SEARCH]. Backstory: I was prescribed 40mg Dextroamphetamine IR for ~10 years, circa 2003-2013, and even after daily use the whole time, the meds still never failed to make me euphoric/productive/energetic. Speculation: Neurotransmitter imbalances, a step deeper in the stream of med adjustments, may be encouraged by either set of drugs because they do have different methods of action. Do go down on the blog to Ezine Articles: I have many there on the window, and my new book hits that subject in great detail – the Med Rules book. It’s a bind that does loop back to the patient to keep looking.


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