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Is it common to grow tolerance? Afraid of long-term high dose use

Is it common to grow tolerance? Afraid of long-term high dose use2011-10-22T04:36:27+00:00

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  • #90001

    Anonymous
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    I came to the very frustration revelation last night that the 50mg vyvanse is officially doing nothing =(=( *huge pout*. It worked really well.. i was able to do things I was never able to do like.. periodically clean the house, do school work in advance in order to plan time off, finish a to-do list etc. I didn’t realize its awesome power until it went away =(.

    so now my sink is completely piled up. running out of silverware again. did absolutely nothing for the two days I had set aside for school work and errands. have to pull off the side of the road if driving more than 40miles due to head bobbing. and I am so overwhelmed by everything..

    LIFE IS SO COMPLICATED. TOO MUCH CRAP TO KEEP TRACK OFF. it is spinning! working (stressful job) but just one online doctorate class. but just so much stuff.. daily life stuff.. like work.. classwork.. grocery shopping.. house cleaning. keeping up with friends. remembering to pay bills.. send people greeting cards.. maintain the car.. reply to emails.. keeping up with facebook (i know lol…but still…).. trying to exercise.. having a boyfriend. and what is so stupid is that a lot of the trivial things are really getting me down. just too many things. I’m an obsessive person and only have enough energy to obsess over one thing at a time!!!!

    i am so used to just being a full time student with other student friends. i lived in a little apartment. time was flexible. i spent ridiculous amounts of time with classwork..and felt overwhelmed too.. but at least I could keep focus on one thing!!!! I just don’t know what to think anymore. i think about everything and nothing gets done. NOTHING.

    so…i had this panic (not actual panic attack, just this general sense of anxiety) and have had this panic which has been slowly getting worse… (not the only reason… have had really bad insomnia this month.. i have bipolar and it is that time of the year- but i’m not manic as I can still relax pretty awesomely if not overstimulated..or if not understimulated =P.) but even so, i felt so much more calm when I started taking these meds in june).

    ok so I am freaking out that Vyvanse 50mg is not doing anything for me anymore. it is nearly the highest dose! I don’t want to take more because I’m already having insomnia issues. and I already have slight withdrawal when I don’t take it. I’ve been not taking it over the weekend to purge my body of stimulant which seems to help with my sleep and appetite. (but get absolutely zero done lol). I feel a little lethargic, super hungry, and extra scattered. i mean its not that bad.. i do go hiking. went to a festival last week. ok.. but i can still feel it. or maybe just scattered in comparison? i no longer know how scattered I usually am or am not.

    what if i get on over maximum doses? like if i grew tolerant to 70mg. what happens then???? what happens to my brain when I take breaks from it? am i just going to sleep and eat all day like I am coming down from meth??????? am I going to be afraid of that coming down and get obsessed about not being without it????????

    ok breathe…………

    today I just took dextoamphetamine in replacement of vyvanse. actually seemed to do better. come down was more noticeable. not horrible, just felt like wanting to run around a store and touch everything but take a nap simultaneously. exhausted hyper is a weird feeling. maybe that is why people get angry and moody? I don’t really get moody from these things.

    ummmm..what was I saying…………………………………?????……..???

    I recently had a thyroid test which came back slightly hyperthyroid (i am treated for hypothyroid). weird in that i had been normal for 3 years after being treated after a year of mild hypothyroid. so I’m sure that this contributes with the simulants both to increased metabolism, insomnia, anxiety (vyvanse used to decrease), and weight loss… but I had a similar hyper test in May and I stopped the thyroid meds. and my doc told me to start them again in august after my thyroid reverted close to hypo. june-august were awesome months… thyroid meds are dead to me right now. I am pissed that the doctor put me back on them prematurely.


    ok ramble sorry..

    so initial question….

    Is it common to grow tolerance? did a dose and med eventually just keep working without adjusting?

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    #108120

    Anonymous
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    #108121

    Anonymous
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    Hey Sugargremlin-

    Keep in mind that I am no expert, so take everything that I am about to say with a grain of salt.

    To my understanding, YES, it is possible to grow a tolerance to amphetamines/other stimulants. Keep in mind though, that there are two aspects to ‘growing a tolerance’.

    1- When you first start taking a new medication, your body needs some time to get used to it. Until your body grows more accustomed to the medicine, you may experience some strange effects.

    For example, I recently started a higher dose of Dexedrine. For the first 5 days, I felt GREAT! My symptoms were under control, my thoughts were clear, and my speech was smoother. My sense of touch was also more sensitive. My skin felt ‘tingly’, and I noticed tactile sensations that I would normally have ignored. I was largely side effect free, except for a slightly decreased appetite, and an especially dry mouth.

    After a few days, I noticed that my skin was less ‘tingly’, and the effects of the medicine felt a little less pronounced. My mouth was also less dry. I asked my doc about it, and he said that I was simply getting used to feeling ‘normal’. Now my focus is great, my appetite is fine, and my mouth feels normal too. It isn’t tolerance, my body is just more used to the medicine.

    2- The dopamine receptors can eventually become less sensitive to stimulation. Taking a short break from the medication can help minimize this. I also heard that taking a secondary medicine like amantadine/memantine can help combat this type of tolerance.

    Here is a link to a forum post about those medications: http://www.addforums.com/forums/showthread.php?t=80317

    So yeah, tolerance happens, just be sure that it is actual tolerance, not just you getting more used to the medication.

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    #108122

    nellie
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    Post count: 596

    Well I can’t answer the question directly but …

    maybe your sleep issues and other health issues are compounding the seeming lack of effectiveness?

    I was recently thinking it (30mg Vyvanse) wasn’t working all that well then decided to really try and address my sleep issues . So started forcing myself to go to bed earlier – low and behold I felt far more alert and suddenly had a noticeable increase in daily productivity. When I first started to take medication the doctor mentioned that stimulants don’t work as well when you are tired. Now I ‘m still not sleeping as soundly as I want to but just an hour of extra sleep albeit Imperfect made a huge difference.

    Now, I know telling you to get more sleep isn’t likely to happen since this is problem for you as you’ve said in the past, but maybe taken together with all of your other issues might at least explain the seeming reduction in effectiveness?

    So that probably wasn’t altogether helpful but wanted to throw it out there:-)

    Also sounds like you are obsessing over all sorts of stuff at once. Maybe you need to address one health related thing at a time. Thyroid sounds like top of the list . But Im sure theres lots more you haven’t mentioned :-)

    Just cut out everything in your life that’s not essential and just concentrate on one thing at a time. So what if the dishes don’t get done- that’s what paper plates are for :-)

    I recently decided to whittle my day down to what I call one “major” thing a day in addition to certain routine things. It has really helped to keep me from feeling overwhelmed or guilty about how I spend my day.

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    #108123

    Anonymous
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    Nellie’s approach sounds helpful, cutting out non-essentials as much as you can and choosing a focus for the day. It’s pretty hard for me to do that, I always want to add in stuff. It helps to have someone to keep you on track – I’ll rattle off a to-do list for the day to my husband and he’s the one that will say “we can’t get all of that done in one day”. He’s also the one that will remind me that I’ve just added something ELSE to the list, that I forgot we planned on doing something different. My mind always wants to fill in the gaps, to add something else from my massive to-do list rather than just enjoying a gap.

    Maybe you need a break from everyone else – like taking a vacation, but take it from Facebook, card-writing, meal-prep, car and house cleaning, etc. Get out the picnic plates, like Nellie said. Live with a little bit more dirt and clutter, get take-out, etc, if only to allow yourself to just focus on a few important things temporarily. Your friends and family should understand that, if they don’t, tough luck!

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    #108124

    Anonymous
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    theselfproclaim….. I’ve never heard of namenta and ADHD. interesting. I’m pretty sure effect is gone too. everything is just as disorganized and procrastinated as before I even began this cycle, but definitely an important distinction!

    nelllie-

    “Also sounds like you are obsessing over all sorts of stuff at once.” YUP!!! I got so worked up the other night that my boyfriend carried me to my bed and laid me flat on my back. hrmmmm may have been the night I wrote this lol. i think it was. I can get very easily overstimulated. and the stimulation accumulates throughout the day, making me explode at night. the problem with putting off things like dishes is that I can get extreme with procrastination.. ie. no silverware left, floors so dirty that one cannot walk barefoot, petrified dead bugs and dust bunnies of doom, cockroaches =( still need to call my landlord so so so disgusting, run out of food to the point of going hungry, put off writing an email for a month.. totally ridiculous. however, when I think about everything at the same time, nothing gets done and the list just grows!!!! There were 3 months, when I honestly had all this crap under control!!!! so it is possible.

    sleep. this is definitely a factor in helping focus. and I haven’t given up. I now have nearly two months of sleep data in that excel document. I haven’t really made any progress, but I won’t give up on it. I got 7 hours out cold last night which was pretty awesome. although a result of some pretty severe sleep deprivation from the two nights before. I know that sleep is central to this.

    no dopamine-

    i have recruited my boyfriend! He is not the paragon of good concentration and has a similar night owl streak. However, it seems like I’ve captivated him enough to pull together enough focus to focus me lol. I’m a good long-term motivator ie. education, career-building which he lacks. He seems capable of day to day focus which is what I lack the most. after a stream of ramble, he seems to be able to filter out suggestions of what I should do now. and yes yes to vacation!!! this weekend was pretty rejuvenating (minus the sleep dep). just time away from my house and life. I have a vacation planned for the new year =).

    thanks guys =)

    -thyroid and sleep are number 1 right now. just as long as I have a spoon left, enough food so I won’t starve, and to look after the cockroach problem..then I’m good.

    =)

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    #108125

    nellie
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    Sugar:

    Ramen noodles, microwave Mac & cheese, lean cuisine in freezer –:) No dishes there and throw away plastic utensils. Works for bachelors, students and teenagers too lazy to cook.

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    #108126

    Anonymous
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    Sugargremlin, the person you choose to help doesn’t have to be good at everything, they are just there to help you through your weak areas.

    Glad to hear you got a good night’s sleep – I cycle like that too (sleepless and then zonked because my body has no option but to sleep) but meds are helping me a lot.

    Food – we just bought a lot of vegetarian beans (pork and beans style without the pork) on sale, easy to make, good protein, can be microwaved, just make sure you rinse the spoon and bowl good afterwards so the bean sauce doesn’t stick and you might as well wash one bowl and spoon while you’re there – DISHES DONE! Also, you can buy good soups in mason jars that you just heat up, sometimes we add extra veggies to them like canned corn or beans. Check out the already cut-up veggies at the grocery store, it’s a bit more expensive but cheaper than trying to make them up yourself and having to throw out stuff because it goes bad before you get to it.

    Article in the news this morning says that even if you have heart disease gene in your family, eating a lot of veggies (we try to do raw) and fruit is an antidote.

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    #108127

    Anonymous
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    I’m on 40mg of Ritalin a day and I’m having that problem. Originally I was on 20mg (My doctor had me on 5mg, RIDICULOUSLY, and I had to take 4 to feel any effects at all, so 20mg) and then my doctor tried me on Concerta & Adderral when I said it wasn’t enough – those things didn’t help at all and only had bad side effects, so i got back on the ritalin, but now a 20mg pill doesn’t do anything except make me moody. 40mg works for 1-3 hours but then abruptly stop. I hear 60mg is the limit but what if i just keep building a tolderance? This is the only med I’ve found that works! I’m petrified of it not working anymore some day. I just got my diagnosis this summer and I don’t even take the meds regularly (esp since i have to take 2, than another one a few hours later to get more than 2 hours of productivity) but I don’t know how I went 24 years without using them. No wonder i dropped out of HS! :(

    This was unproductive, but yes, i feel you! I also notice no amount of meds help if I haven’t slept well. I have a toddler and a possible seizure disorder though, so that is the norm. :(

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    #108128

    Anonymous
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    nellie and no dopamine- spot on again!!! i have a freezer filled with lean cuisines and a cupboard filled with canned progresso soup lol. I add frozen green beans to the soup and sometimes some whole wheat noodles. I pour the soup back into the can as my bowl lol. I named this cuisine “bum can soup”. kashi go lean cereal with protein to serve as meal replacement. PB&Js. Meat and cheese sandwiches as long as I use the same meat and cheese each time to avoid waste. lettuce and tomatos are a no go due to high spoilage potential. I’m a big fan of energy bars too. lol. i should pick up a can of beans and a frozen bag of vegetables.

    twilightfades- i see my psych doc tomorrow so I’ll post the outcome. Maybe you need a second med on top of it such as strattera or wellbutrin (would need close supervision of course as it mixes two classes!)? Do you take anti-seizure meds? sorry, you are going through similar feelings of fear.

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    #108129

    Anonymous
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    i posted some long answer on one of these threads.. i have a few of them which pretty much turned into the same post lol. I talked to my doc about it (and tons of other stuff). I’m going to switch to the quick acting dextroamphetamine. We didn’t want to raise the vyvanse because vyvanse is odd in that raising the dose makes it last longer and that is the last thing i need. I need it out of my body by the time I need to sleep! so the dex is more adaptable. It seems to still be doing something although not ideal. I really really really need some resolution to my insomnia which is my most concerning problem right now. upped the sleepy meds. then, I got something to calm me down before i start getting ready for sleep because I get too wound up and can’t even make it to bed enough to leave myself more than a 6.5 hours sleep period.

    she wants to see me again in a month to then re-evaluate. If I am more rested, then my focus is going to be improved. thus, maybe the meds will work better? she was also concerned by the possible tolerance. So I think that if I continue not to get relief from the dex when I am sleeping reasonably, we will change meds. also, i stopped taking thyroid med so hopefully will get more sleep when I get out of hyperthyroid range. we had discussed possible uppage to 20mg twice a day, but too risky for the bipolar. She was thinking adderall.

    I am looking forward to chilling out again. the insomnia and hyperthyroid crap need to stop. THEN… tackle the ADD. (although I am still treating it as I get so overwhelmed at work and balancing life that the stress is counterproductive.)

    too much thinking and not enough things being crossed off the to-do list!

    edit: going to get a sleep study! twilight, must look into the possible seizure. I am finding out that ADD can’t be effectively treated without treating all the comorbid crap.

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    #108130

    billd
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    Yeah my problem is that my neurologist is basically refusing to test me for seizures because he said the add and vassodepressor syncope re my only problems. It’s causing me so much stress I can’t even… I have to take another dizziness test to schedule before hell see me again. My massive limb jerks on top of all the other symptoms just aren’t convincing enough, I guess… Hate doctors. I have had to fight tooth and nail with my psychiatrist to get on my Ritalin. She prefers to switch me to a different band all minimum dosage every month instead of just upping my dose. I should look into the vynnase, my other problem is that even 40mg of Ritalin, the only med that works, only works for an hour! I’m so sick of failing classes and getting bad grades because my doctors refuse to listen/aren’t good at what they are doing. My psych sits there and googles the mess before she gives it to me because she knows almost nothing about them. Soooo who knows.

    Good luck! I hope you get the other stuff figured out ASAP!

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    #108131

    Anonymous
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    sugargremlin – have you ever heard of Debbie Meyer Green Bags? They sound hokey but they really do work. I use them for bananas all the time – if I didn’t, I would only buy one banana at a time from the store (but now I buy 6 at a time). They’re supposed to work well for things like lettuce too. They really do keep things fresher longer. And I get a lot of mileage out of one bag, we do rinse them from time to time.

    I have been working with the doseage of modafinil (generic version of provigil) which is a narcolepsy drug. I was told not to take this particular drug past 1:00 in the afternoon, it has a half life of about 12 hours, so it’s still in my system late at night. I was struggling with the single 100mg dose at breakfast not being enough, so I added a second 100mg dose at 1:00. It helped with the daytime sleepiness and I had great alertness, but was still fragmenting my sleep. Someone on a narcolepsy site suggested I take the second dose earlier, around 11:30 or 12:00, and that has helped, basically I am burning it off earlier. I suppose I could try to split the pill and see if half a dose would work too. But my experience with it is that it’s challenging to find the right dose that keeps you alert during the day and then allows you to sleep at night. I am feeling pretty settled right now even though I am still waking up a few times during the night, it’s nothing like it was before, which was every hour, sometimes only 20 minutes of sleep at a time. I totally relate to what you’re going through.

    I have found that I am going to have to curtail much of my usual nighttime activities, in order to work with the meds and my new diagnosis. So no computer after 9 pm (or even earlier if possible). No reading when I go to bed (I use the dusk simulation and it’s very helpful). No overstimulating movies or that sort of thing in the evening. No staying late at work to try to keep up or get ahead. When I leave work just after 5 pm, it’s home for dinner and then keep unwinding until bedtime, which is starting to be 10 pm or earlier. Previously I would try to do anything and everything on my massive to-do list at night, working well into the evening and early morning at times, completely wired up and charged with creativity. I figure it’s just not worth it for me.

    Hope the dex works for you.

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    #108132

    Anonymous
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    i’ve seen those bags before. i was tempted, but i figured that i would forget to use it. =P something to think about.

    sounds like you need more modafil. narcolepsy is serious sh(* so that warrants as much as you need!

    what are you going to do???? no computer or reading?? oh man. i would pace and house in confusion. so so many bad habits. but as you say.. it is truly not worth it. I am so overwhelmed to the point in which I feel impaired. some of it is ADHD, but not all of it. and I’m sure that I could get better mood control with better sleep. My mood control is actually rather good for having bipolar disorder (i have overcome a lot and have been extremely vigilant and consistent about my treatment). sleep has always been my one deficiency. the stress of feeling overwhelmed with life management is another. no matter how stable I am, i always feel like I am holding onto functional by a few threads (ADHD, anxiety). and wasting boat loads of time which makes me feel bad (ADHD).

    some improvement with the dex. and my skin is clearing up. weird that i got more acne with vyvanse.. or maybe was the season? oh man..who knows, right? the upped sleep meds were helpful last night and I got better sleep. i was still up a few times tossing and turning, but i feel like it was enough. I am still waiting for some deliciously amazing sleep…oh man…. i almost got that sun night, but was interrupted by work (nearly total sleep deprivation for two days, driving, and hiking). focus is noticeably better with good sleep. if I could get the ADHD under control, i can time manage well enough to do all these little things i like to do on the computer at more healthy times. can’t get it control until i control my sleep………..

    my doc gave me lorazepam to take a few hours before i want to sleep to chill me out and induce me to want to go to sleep. worked well last night and i was in bed by 1am (which is awesome for not having to get up early the next morning).

    twilight. maybe get a second opinion? have you ever had a EEG? maybe you are having absence seizures? muscle jerks could be tics? depends on what they are like. you at least need someone who is going to listen and at minimum explain to you why he/she came to such conclusion. do you get tutoring? many many people with ADHD also have some learning disabilities like dyslexia etc.

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    #108133

    Anonymous
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    @twilightfades – I hear your frustration. Have you thought about getting a second opinion? Muscle jerks are nearly always combined with altered consciousness in seizure disorders, so I am not sure if this matches your symptoms or not. Your psychiatrist sounds like a bit of a worry, though there are so many different drugs on the market now, that nobody would be able to remember all the drug dosages, uses, prescribing laws, and the interactions that occur, so it’s good that he recognises his limitations and researches things before prescribing. But seriously, it sounds like you need another doctor to investigate things, just to give you peace of mind.

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