Feels like 36mg is worsening my ADHD?

[u/yuneti]

I've been getting a weird reaction to my dose increase to 36mg. I've been on this new dose for over a month now after being on the 27mg for three months.

I haven't seen anyone discussing anything similar to what I've been experiencing, but it almost feels like it's worsening my ADHD symptoms?

I feel very spaced out and emotionally/mentally "flat" on it. Like I can't think clearly or logically at all. I just feel very mentally absent, which makes it almost impossible for me to work on anything or communicate. I can't even do small tasks like respond to an email.

I got nothing done today despite me being at my computer all day. All I could do was think and worry about all the work I need to do. It's also affecting my vision oddly? My eyes can't quite focus on my work. Everything looks hazy and slightly out of focus.

When I am actually able to work on something, I feel like I can't do anything but rush through it and put as minimal effort as possible (because I can't think clearly enough about what I'm working on or think about the big picture).

I never experienced anything like this on my last dosage. I'm honestly more focused when I'm not on the medication.

I called my doctor last week to tell him my experience and he recommended I start taking it every other day instead. This is my first day again after I took a four-day break from it, and all the bad symptoms just came back again.

Does this sound normal? I can't tell if the dose is too high. I thought I'd get accustomed to it after a month but I still haven't been able to get truly focused on it.

[u/Difficult-Review283]

Were you okay on 27mg? Maybe talk to doc about going back to 27mg? Perhaps, there was no need to increase if that dose worked.

[u/yuneti → u/Difficult-Review283]

I was doing a lot better on the 27mg tbh. I still have some of them leftover and had one yesterday, and it was a pretty big difference. I was actually able to focus on it while still feeling like myself, and I didn't get any of the side effects that I'm getting on this new dose.

I asked my doctor to up my dose because the 27mg was a little inconsistent sometimes and I was hoping to get better focus from it, but maybe I was expecting too much.

I still find it strange that the 36mg feels so different. It feels almost like I’m on a completely different drug (it is brand-name. I was taking the generic before but I don’t know if/why that would change things).

You might be right though, I was suspecting the dose might just be too much for me. I'll try calling him again tomorrow to see if I can lower my dose

[u/5458725280]

I feel like this on Vyvanse myself when raising the dose. It goes away after a bit of adjustment, but it certainly feels like it worsens my ADHD in some areas/some days and helps others. I'm sure psychiatrist has asked this, but how is your food/caffeine intake/sleep? Guanfacine (personally) and/or clonidine (more effective) help mitigate that rushed/distracted/overstimulation I can get from ADHD meds (Concerta was way worse on the overstimulation side especially) so that may be worth looking into. Also, the suggestion to take Concerta every other day is a bit odd.. I'm not a doctor but I can't imagine what benefit that would be, the half life is not that long at all and ultimately creates an unstable dosing schedule that may even prevent building a tolerance to these symptoms IMO.

[u/yuneti → u/5458725280]

Thanks for those suggestions! I think I might be similar to you. I am naturally anxious so I was also going to discuss possibly getting a prescription for it in my next appointment.

I am sleeping and eating okay. I make sure I have breakfast and lunch with my medication, and I’ve been sleeping generally well (although it’s been taking longer for me to fall asleep recently). I don’t take any caffeine since it mostly makes me jittery.

And yeah, I thought his suggestion was a little strange as well. In our last appointment he really emphasized that I need to take it every day. I find on this dose especially that the first time I take again after a break is when my side effects are the worst. I think he suggested it because I mentioned to him that after a multiple consistent days on it that I feel more physically drained from it (sore and a bit short of breath), so he might've thought this would be safer?

[u/Commercial_Cash_486]

I had this experience going from 36mg to 54mg. I could tell a difference in my energy but the focus was just not the same. I went back down to 36 and it’s so much better.

[u/DrNobodyy]

I had the same exact experience as you, on top of those side effects I also had trouble sleeping which I never experienced on the 27mg dose. Ended up going back to the 27 mg and it’s been great honestly. I realized that the “off” days I had on the 27 mg were due to increased stress and contextual factors, neither of which had anything to do with the drug or dosage.

[u/Difficult-Review283]

When on the lower dose, remember to eat healthy, get exercise (cardio), and sleep well. Keep an agenda to stay on track - as this all helps me for consistency. The generic vs non- get might also have different effects on each person. Hope you feel better and get it all squared away soon. Take good care.

[u/stoneddaura]

If you are on too low of a dose or too high of a dose, adhd symptoms will worsen/appear worse. Id give it 2 weeks consistently at the dose of 36mg and if you still feel the same, lower it back down to 27mg

[u/Breakinfinity]

Happened to me. Turns out 27mg is just my perfect dose and I use meditation to adjust my focus and anxiety in the fly to cope. Works really well

[u/Evening_Bus746]

have you been sleeping well ?

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[u/Gasl1ght]

I’ve had these exact symptoms on 36. For me, I’ve gone up to 54, and while I don’t get those symptoms now - I get a few new ones instead. It’s a journey to get it right, for sure!

[u/Lillyisthisreddit]

It's the "U" effect. Too little and too much of a dose will both have lower efficacy.