this post was submitted on 17 Oct 2024
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ADHD

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Elvanse - safe low dose? (lemmy.ml)
submitted 4 weeks ago by AddLemmus@lemmy.ml to c/adhd@lemmy.world
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As suggested myself and encouraged by the doc, I'll take a fraction of a normal dose to check it out first. He signed off on any dose that is lower than the one he prescribed (30 mg in the morning), and the capsules are intended for opening and dissolving in liquid.

So, I'm very sensitive. Low dose opioids for a cough give me euphoria, and when I tried Modafinil, 1/4 of a pill (2 pills is normal!) turned out to be just right for me.

On one hand, I could really use the full productivity boost tomorrow, which would mean trying 1/4 of 30 mg, 7.5 mg. On the other hand, safer would be 1/8th again as it was with Modafinil. Then again, 1/4 of the Modafinil dose was "bearable", it was not intense suffering.

Trying 1/8th in the morning and another 1/8th at noon if the effect is really as low as a cup of coffee could also be an option, with the risk of losing sleep. I tend towards that option.

Some of the worst hours of my life were on the minimum dose Venlafaxine (and many report that), so I'm careful.

What do you think? Doing the super-low 1/10th test at 4 pm would still take away my sleep, right?

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[–] SteelCorrelation@lemmy.one 5 points 4 weeks ago (1 children)

Remember that sleep is extremely important for everyone, especially us neurodivergent folks. I would not recommend taking any stimulant past noon. Hell, I struggle with sleep as it is and I take my ADHD medication at 6 AM.

I have a feeling that you'll adjust quickly and need to up your dosage to get any effect. I find that my body adapts very quickly to medications, especially stimulants. Unfortunately, that means building a tolerance over time and requiring either a long break or upping my dosage.

I'm not a doctor, so I can't give you advice on dosage. I just wonder how you'll measure it.

[–] fossphi@lemm.ee 3 points 4 weeks ago (1 children)

I'm not on any medication yet so can't really compare. But where do you stand on caffeine? I guess it's technically also a stimulant but since it doesn't seem to have any effects on me I sometimes drink some in the evening for the taste. And it doesn't alter my sleep/tiredness at all

[–] SteelCorrelation@lemmy.one 3 points 4 weeks ago

The evidence that I'm aware of suggests that we with ADHD process caffeine differently, but it still has an effect on the brain which can affect one's sleep. I drink caffeine in the morning because it helps me calm down and focus while I wait for the medication to kick in.

[–] tgm@lemmy.world 3 points 4 weeks ago (1 children)

30mg seems to be the initial dose for adults and children source. So you could start af low af you want, but you might need to increase dosage over time to get any effect.

If your doc signed off on any dosage below 30 and you are afraid of a strong reaction, you could start as low as 10 or 5mg, but most ækel wouldn't experience much.

If you have several capsules you could start very low and increase until you fell an effect.

Do not exceed the doctors recommendations and give each dose a day or two (you ingest a given dosage for one or two days) to affect you.

I am not a doctor, so stick to what doc says, but the smallest dose of Elvanse I could five was 20mg as a maintenance dose.

[–] AddLemmus@lemmy.ml 1 points 4 weeks ago (1 children)

Thanks! I'll play it safe and would rather start with 5 than 10 mg.

[–] tgm@lemmy.world 2 points 4 weeks ago

I would like to add that you are unlikely to feel much at those doses, but you safely start low and go up until you feel an effect.

Furthermore, not everyone experience net benefits from medication, so you shouldn't increase the dose if you feel bad.

Finally, I am not a doctor, neither are most other people on here so consult your own doctor the moment something feels off

[–] bestboyfriendintheworld@sh.itjust.works 2 points 4 weeks ago

4 pm is too late to take and stimulants.

Take a low dose and wait at least 40 minutes for the effects to fully kick in and feel if it’s a good dose for you. Take more if the effects are too weak.

If you redose at noon, you will mostly extend the duration, not increase the effects.

[–] hollyberries@programming.dev 2 points 4 weeks ago (1 children)

Not a pharmacist or giving advice.

My psychiatrist started me off at 20mg of the slow release in January of this year and upped it to 30 a month ago (also slow release).

Is there a reason you are prescribed the 30 and not the 20? To me that makes more sense than expecting you to split a 30mg capsule four ways... Also if you have to spread it out throughout the day you might be better off with a rapid release tablet which can be cut more evenly with a pill cutter.

I found that taking mine as soon as I wake up gives the most beneift as it takes an hour and half before it starts working. Taking it after 09:00 makes me unable to sleep.

[–] AddLemmus@lemmy.ml 2 points 4 weeks ago (1 children)

I don't know why he does what he does, but he said that I should find the ideal dose, which often is between two capsule sizes. He encouraged me to take any dose lower than 30 mg for the first month, and after he sees me again to fine tune it by dissolving in water.

I dissolved it in some water in a protein shaker with marks, so I can take exact 3 mg doses (10 % steps).

Only thing I don't like about this is that children are in the house, and there should not be deadly poison water standing around anywhere. The capsules are in a lockbox.

[–] AddLemmus@lemmy.ml 1 points 4 weeks ago

First test: 5 mg (~ 15% of 30 mg) at 8:30 am.

It kicked in really hard, like a thick line of quality speed. It didn't feel like something that a doctor would prescribe. Got a lot done, then hard crash at 12:30, lying down and dozing off for 20 minutes. The mental effect was at least as good as it was with Modafinil: I tackled the most urgent todo without mental effort and little chores just "happened". But with a high like from recreational drugs.

Maybe what contributed was that I did a quick, but intense workout.

So it was perfect - a very safe dose, yet also the productivity boost I needed for the day. 10 mg might also have been fine, but taking the entire 30 mg (or even 20) would have been a mistake. Certainly no risk to not feel anything.

I wonder if I should take another 2.5 mg for the afternoon, or just use tea and coffee as usual.

This strange effect regarding intensity and duration was no surprise - I observed that with other medication and drugs before, the doctor understood it and took it into account, thus the individualised instructions.

[–] Zombiepirate@lemmy.world 1 points 4 weeks ago (1 children)

This is a question for your pharmacist; they should be happy to help if you give them a call.

Not trying to be rude, but it's a bad idea to take medical advice from people on the Internet.

[–] MrPoopyButthole@lemmy.world 4 points 4 weeks ago (1 children)

OP has established that they are being safe and working within their docs guidelines.

[–] Zombiepirate@lemmy.world 2 points 4 weeks ago

They asked random people on the Internet for dosage advice when there is professional advice available for free.

Why not use informed free advice instead of dubious free advice? How is that responsible?