# Intuniv + Vyvanse or alone



## GotAnxiety (Oct 14, 2011)

I've never tolerated stimulant's that well they always seem too cause more problems then there worth when ever i check my blood pressure after taking a stim it's considerable high like around 140/100+ side effect as in increase aggression, anxiety,depression feeling like im freaking out inside but i got no way too express my self, drug induced, ocd as well anti social behavior, 

When ever i drank alcohol, it was quite the opposite i dont drink too much any more cause it causes too much health problem's, but it felt like the front part of my brain was activated after drinking.... and usually when taking stimulants my central nervous system was more activated,

it sound weird, it would be awkward explaining this too a Doctor they probably look at you like a drug addict or something.

What leads me too my question here Intuniv not yet approved in canada im just curious if anyone out there has had experience with it, or in a combination with a stimulant and is it practical taking it long term or do you just develop tolerance too it like everything else ?

or maybe all those year's as a kid on stimulants may of cause permanent anxiety and being sedated help's when i drink i feel like the real me

Current medication Lexapro, Ramipril


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## Noca (Jun 24, 2005)

As far as I know Intuniv only helps with hyperactivity and doesn't help with concentration. I think it only works on NE, iunno. Aggression is usually part of the hyperactive part of ADHD.


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## GotAnxiety (Oct 14, 2011)

Well if it just work on NE, won't my brain up regulate too over come the effect's concentrating never been a problem, not enough activity in the front part too much in the central nervous system instead of using stimulants too release chemical's in your brain this can depress them so your body can respond by up regulating it's own


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## moke64916 (May 31, 2011)

Suggestion: don't get on any stimulant medication at all. It's fake energy, false sense of no anxiety, false positivity, false joy. It leads to dependency whether or not you have ADD/ADHD. It's extremely hard to get off of. Especially adderall. Trust me. Been there done that.


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## Huk phin (Oct 30, 2011)

I take Vyvance for ADD and I have the same problems. The stimulants are effective but if the dose is too high, or I drink too much caffeine, I become an anxious wreck. I have struggled with the idea of just giving up on the stimulants. I was just given a prescription for propranolol yesterday. It is also a beta blocker that I am hoping will counter some of the nervous system stimulation.


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## barry1685 (May 25, 2011)

Huk phin said:


> I take Vyvance for ADD and I have the same problems. The stimulants are effective but if the dose is too high, or I drink too much caffeine, I become an anxious wreck. I have struggled with the idea of just giving up on the stimulants. I was just given a prescription for propranolol yesterday. It is also a beta blocker that I am hoping will counter some of the nervous system stimulation.


Beta blockers are awesome combined with stimulants to control the heart racing effect stimulants create. I can attest to this because I used metoprolol with vyvanse. I do not think your anxiety will decrease long term with beta blockers. But it will get rid of the fast heart race.


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## swim (Apr 4, 2011)

it would be nice to have some addy or vyvanse or ritalin especially when I go to clubs and want to stay up all night, rather than E tablets I will never ever touch that **** anymore


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## GotAnxiety (Oct 14, 2011)

Yeah i kinda given up on stim's i found lexapro too be more effective.... i've only been experimenting with a low dose of coffee or caffine, but even that pushing it, been also trying a cup of red wine at night... it's seem some of my cogitnive ablitities improve with that, more natural then the heavy duty Intuniv and Vyvanse combo


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## Jericho187 (Jan 18, 2011)

barry1685 said:


> Beta blockers are awesome combined with stimulants to control the heart racing effect stimulants create. I can attest to this because I used metoprolol with vyvanse. I do not think your anxiety will decrease long term with beta blockers. But it will get rid of the fast heart race.


You have to be very careful combining beta blockers with stimulants.

Sure you are blocking the beta receptors with metoprolol, so your heart will slow down, but remember, beta receptors are also used to dilate the arteries in your heart, liver and muscles.

Because you took the Vyvanse, you now have a ton of adrenaline in your system that can roam freely and stimulate the alpha receptors causing massive constriction of the arteries all over your body. The beta receptors are helpless to open them up and balance everything out because they are blocked from the metoprolol.

I'm sure at low doses this can be managed, but I would check your blood pressure when you do this and make sure its not too high. The only beta blocker I would take with a stimulant would be labetalol because it blocks both beta and alpha receptors.

Thats why we never give beta blockers in the ER to crack addicts who overdose.


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## jim_morrison (Aug 17, 2008)

Jericho187 said:


> You have to be very careful combining beta blockers with stimulants.
> 
> Sure you are blocking the beta receptors with metoprolol, so your heart will slow down, but remember, beta receptors are also used to dilate the arteries in your heart, liver and muscles.
> 
> ...


+1 Yeah I think that's why tenex (intuniv) is more commonly prescribed with stimulants. It enhances alpha-2 receptors (which are inhibitory and reduce the release of norepinephrine), but it leaves all beta and alpha receptors open.


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## The Professor (Jul 31, 2011)

moke64916 said:


> suggestion: Don't get on any stimulant medication at all. It's fake energy, false sense of no anxiety, false positivity, false joy. It leads to dependency whether or not you have add/adhd. It's extremely hard to get off of. Especially adderall. Trust me. Been there done that.


^listen to this


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## Noca (Jun 24, 2005)

The Professor said:


> ^listen to this


Sure if you dont suffer from ADHD...



> Adults with untreated ADHD are more likely to experience lower educational achievement and are less likely to graduate from high school or college. They are inclined to have low self-esteem, anti-social thoughts, a pessimistic outlook on their future and problems with their romantic relationships and jobs. Furthermore, adults with untreated ADHD are twice as likely to be divorced or separated.
> 
> Untreated ADHD can lead to increased stress, depression and poor mental or physical health. Additionally, adults who do not treat the disorder are likely to engage in harmful behaviors, such as smoking, using recreational drugs and unlawful conduct. These adults are also at risk for frequent personal injuries and are four times more likely to be involved in a motor vehicle accident.


http://www.nmha.org/go/information/get-info/ad/hd/adult-ad/hd-in-the-workplace



> People with ADHD commit crimes for many of the same reasons as those without ADHD: Some want money or property that belongs to others and have little motivation to acquire the loot honestly. Those with ADHD also have other triggers for crimes; adolescents and adults with untreated ADHD are often bored, sensation seeking, or simply impulsive, and this combination of attributes leads them to react with poor judgment. A desired item appears, they want it, so they take it.[1] It also appears that when individuals with ADHD commit violent crimes, these acts are more likely to be crimes of spontaneous and "reactive" aggression rather than carefully plotted out offenses. Such crimes are generally impulsive acts driven by a provocation or conflict that triggers an outburst. Research with adult male offenders seems to bear out this hypothesis.[2]
> 
> Studies show that at least 25% of prisoners in the United States have ADHD. The recidivism rate among all felons is high, and an estimated two thirds are rearrested within about 3 years.[3] These statistics have important implications for society at large.


http://www.medscape.org/viewarticle/719862


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## The Professor (Jul 31, 2011)

Dr House said:


> Sure if you dont suffer from ADHD...
> 
> http://www.nmha.org/go/information/get-info/ad/hd/adult-ad/hd-in-the-workplace
> 
> http://www.medscape.org/viewarticle/719862


I know, believe me, it's tough. Mine is very severe. But I am currently in the process of getting off adderall (i hope). I can't just keep going up and up on the dosage. It's not worth it. I'm trying to find something better that won't cause so much dependence. The last couple weeks without adderall have been hell, especially in terms of studying. Idk what to do.


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## Noca (Jun 24, 2005)

The Professor said:


> I know, believe me, it's tough. Mine is very severe. But I am currently in the process of getting off adderall (i hope). I can't just keep going up and up on the dosage. It's not worth it. I'm trying to find something better that won't cause so much dependence. The last couple weeks without adderall have been hell, especially in terms of studying. Idk what to do.


Why not use it as needed instead of daily? Works for me.


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## The Professor (Jul 31, 2011)

Dr House said:


> Why not use it as needed instead of daily? Works for me.


I do, but I need it kind of a lot since I'm in college. When I take it "as needed" I end up taking it about 4-5 days a week which is too much.


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## Noca (Jun 24, 2005)

The Professor said:


> I do, but I need it kind of a lot since I'm in college. When I take it "as needed" I end up taking it about 4-5 days a week which is too much.


Mix in short acting amph like Dexedrine IR for days where you do not need an entire use of Adderall XR in order to cut down additionally on the amount of amph you use in a week.


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## moke64916 (May 31, 2011)

Dr House said:


> Sure if you dont suffer from ADHD...
> 
> http://www.nmha.org/go/information/get-info/ad/hd/adult-ad/hd-in-the-workplace
> 
> http://www.medscape.org/viewarticle/719862


Actually even if you do have ADD or ADHD you'll become mentally and physically dependent. I have ADD and I was dependent on it. It didn't get me high. All what it does is bring you present in the moment. I learned how to do that without stimulants through awareness. No one who has add needs stimulants. It just takes more practice to become present in the moment. I have a question. Have you ever heard someone find happiness while depressed on anti-depressants? Answer is no. Only through coping and personal growth does depression pass. Man I used to be depressed as a teenager and no anti-depressant helped me. Only medicine that shows a difference is narcotics. That's it in my opinion. And even that is not a cure.


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## hanzsolo (Jan 2, 2011)

Moke

I am very happy for you that you found a way to become present in the moment, one of the many things stimulants can help with. And yes I know there are dependance issues with stimulants which can make them ineffective over the long term when taken every day. Some people have to use additional meds to manage the side effects and make everything work.

But just because you were able to "find your way" does not mean that meds do not work, or that everyone should just practice being more in the moment and all the problems will go away. Yes in a perfect world we would all practice mindfulness, work on ourselves all the time, exercise, eat well, and some would learn to manage without medications. But what if life is better WITH the medication then without? 

I am not advocating that medication be used long term for everyone - a depressed person may use an SSRI to get out of the rut. Once out, they probably should go see a psychologist or someone to talk about their problems and work on themselves. But does everybody do this? Can everybody do this? Do they have the willpower or the means ? 

I (for example) struggled for many years without medications, then started abusing alcohol, then other substances. I got clean a few years ago and worked on myself constantly, but still found myself very anxious and ADD. 

Although my current regimen is far from perfect and it does have side effects, overall my life is much better then pre-medication. I am in a good mood most of the time, I have low anxiety, good energy, I enjoy time with my wife and baby boy (which used to make me extremely anxious), etc.. 

You say it's a false feeling? Ok, but am I not enjoying my life now? Is that false also? Because it sure doesn't feel false to me. Yes one can argue that meds give a false feeling of this and that, but am I not living day to day much happier and better off then I was before meds ? YES I AM! 

So please have some respect for the people on here that are using medication to help them manage their lives better. Coming on this forum and just saying that it's not a solution blah blah is being ignorant before you have walked in someone else's shoes and know their own struggles and issues. 

One thing I am against is when doctors prescribe medication and the patients are not aware of the side effects. I encourage everyone to educate themselves (if they have not already of course) on all the side effects of any medication they are taking. And if taking multiple medications, check potential interactions and really educate yourself. Only then should a decision be made whether it's worth it to take the medication or not. In some cases it probably isn't. But we are all adults and make our own choices.

Medication should be a "choice" - I know someone that has ADD and is totally against meds, the drug industry, and manages fine without them. She is a very strong, wonderful person, has found tools to manage and has accepted her shortcomings. Guess who? My wife :b Point being, we all have different ways to deal, different views, strengths, weaknesses, we are all unique.

As I have always said, I agree that medications should only be a part of ones regimen to better themselves. Therapy, CBT, mindfulness meditation, regular exercise, proper sleep, proper diet, can all help one along. But it does not always solve the problem for all. At least it didn't yet for me. And believe me I have read every self help book, social anxiety book, seeing tons of therapists, etc. 

Do I plan to be on meds forever? Hard to say. I am constantly working on myself, and trying to lower doses as I am aware of the side effects long term and hope to be around for awhile. But it's always about risk/reward, quality of life, everything has to be taken into account. 

Life is a work in progress, and everyone is on their own journey to better themselves.. 

I mean no disrespect to you or anyone else on the forum trying to manage without medication, all the power to you !!!


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## hanzsolo (Jan 2, 2011)

And to the original OP - yes in some cases (especially if you are not hyperactive and stimulants actually stimulate you versus calming you down) meaning primarily inattentive, you may end up anxious if stimulants are taken every day - and may need something to counter the anxiety such as a beta blocker, norepinephrine blocker such an guanfacine, clonidine or an SSRI. Clonidine is somewhat similar to guanfacine and is available in canada. 

Or alternately as dr house said, your best bet may be to take them PRN as needed. If using them 4-5 days a week (which may or may not be too much monotherapy), try dexedrine IR on days you only need help in the morning or afternoon for example, and try to lower your "overall" intake of stimulants for the week. Dexedrine does not have any levo-amphetamine in it (which targets norepinephrine more and causes some of the "physical" get up and go - which some love and some hate) so it may even work out better for you.

And finally, there are always ways to help stimulants work more effectively using NMDA antagonists such as memantine. There are multiple studies showing how memantine reduces tolerance to opiates, stimulants and even benzos. Reducing tolerance means that the pro social, uplifting feeling that most people initially get from the stimulants (but goes away after days weeks and is replaced with anxiety etc) actually stays. 

But with medications less is sometimes more, and there are always costs and side effects to consider, especially when using multiple meds. I tried over 50 different meds, combos, you name it, been there, done that, and ended up on my current regimen... It's been a long, difficult and costly journey so to speak lol.. 

As always YMMV, trial error (dose, timing, combos, etc) until you find what works for you. 
I would try stimulants - PRN first if possible... And of course - healthy diet, some supplements, 7-8 hours of sleep per night and exercise always seem to help overall..

I unfortunately do not have any experience with guanfacine (being in canada also) so cannot comment there. Monotherapy it apparently blocks NE so may work if you're hyperactive. If not, may be somewhat sedating. 

Best of luck


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## The Professor (Jul 31, 2011)

Dr House said:


> Mix in short acting amph like Dexedrine IR for days where you do not need an entire use of Adderall XR in order to cut down additionally on the amount of amph you use in a week.


I should have clarified, my adderall is IR. I heard dexedrine may be better for SA symptoms so I was about to switch to that once I ran out of adderall but that's when I came to my crossroads. I figured dexedrine was basically the same as adderall in terms of the dopamine downregulation so I held off on asking for that and have not talked to my doc since. I really hope I can find something that's sustainable (see my next post). Right now I'm doing piracetam and caffeine, hoping it may help somewhat.


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## The Professor (Jul 31, 2011)

hanzsolo said:


> And to the original OP - yes in some cases (especially if you are not hyperactive and stimulants actually stimulate you versus calming you down) meaning primarily inattentive, you may end up anxious if stimulants are taken every day - and may need something to counter the anxiety such as a beta blocker, norepinephrine blocker such an guanfacine, clonidine or an SSRI. Clonidine is somewhat similar to guanfacine and is available in canada.
> 
> Or alternately as dr house said, your best bet may be to take them PRN as needed. If using them 4-5 days a week (which may or may not be too much monotherapy), try dexedrine IR on days you only need help in the morning or afternoon for example, and try to lower your "overall" intake of stimulants for the week. Dexedrine does not have any levo-amphetamine in it (which targets norepinephrine more and causes some of the "physical" get up and go - which some love and some hate) so it may even work out better for you.
> 
> ...


Do NMDA antagonists actually correct the underlying cause for tolerance of adderall? (which I'm guessing is downregulation). That would be incredibly great if it did, and I would ask my doc for memantine and adderall/dexedrine ASAP! In other words, if I took it adderall for months and then stopped (like I am doing now), would I just go back to how I normally am without adderall or would I be f**ked?... in terms of motivation/inattentiveness issues.


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## Noca (Jun 24, 2005)

The Professor said:


> Do NMDA antagonists actually correct the underlying cause for tolerance of adderall? (which I'm guessing is downregulation). That would be incredibly great if it did, and I would ask my doc for memantine and adderall/dexedrine ASAP! In other words, if I took it adderall for months and then stopped (like I am doing now), would I just go back to how I normally am without adderall or would I be f**ked?... in terms of motivation/inattentiveness issues.


I have gone on periods of amphetamines 3 times and stopped twice. In the periods between amphetamine runs, my mood returns to normal, my motivation/inattentiveness goes back to what it was before I ever started meds(minus the lack of motivation caused by depression, which post meds is now weakened), and the social skills I learned as well as the improvements made on my SA via exposure caused by amphetamines stays permanently. Improved social skills, which includes my ability to write more effectively in the process, as well as improved SA symptoms, lead me to feel better about myself, thus I am suffering from less depression overall.


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## crayzyMed (Nov 2, 2006)

The Professor said:


> Do NMDA antagonists actually correct the underlying cause for tolerance of adderall? (which I'm guessing is downregulation). That would be incredibly great if it did, and I would ask my doc for memantine and adderall/dexedrine ASAP! In other words, if I took it adderall for months and then stopped (like I am doing now), would I just go back to how I normally am without adderall or would I be f**ked?... in terms of motivation/inattentiveness issues.


Yes, they do block the underlying cause.


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## hanzsolo (Jan 2, 2011)

The Professor said:


> Do NMDA antagonists actually correct the underlying cause for tolerance of adderall? (which I'm guessing is downregulation). That would be incredibly great if it did, and I would ask my doc for memantine and adderall/dexedrine ASAP! In other words, if I took it adderall for months and then stopped (like I am doing now), would I just go back to how I normally am without adderall or would I be f**ked?... in terms of motivation/inattentiveness issues.


Yes in my experience NMDA antagonists do correct the underlying cause - pre memantine, after 1-2 weeks on stimulants, the positive effects vanished and I was left feeling anxious, dazed, over stimulated and frazzled.

When I added wellbutrin and magnesium, it was better but I still had some tolerance related issues.

Since starting memantine (and stopping wellbutrin/magnesium), I still get the mood lifting, positive energy every day I take my dexedrine, and it's been months on this regimen - taking only 1 day off per week. Not to mention the positive energy totally eliminated my anxiety as a result. Plus I am focused, and my mind is getting clearer (since starting to taper down the benzos). And best of all, no crash at end of day and memantine actually protects against amphetamine-induced neurotoxicity 

Taken from another member;
Glutamate is one of the most important excitatory neurotransmitters in the brain, and NMDA receptors activate by binding to glutamate and glycine. If they are not bound to glutamate and glycine, they are inactive. The NMDA receptor channel is the cite of the Ca2+ influx, so by inactivating the channel, you can essentially stop what causes tolerance and even reverse it. NMDA receptor antagonists such as memantine downregulate glutamate, inactivating NMDA receptor channels, indirectly putting a limit on Ca2+ influx and consequently influencing amphetamine tolerance.

The only potential issue with memantine which has been mentioned is that it does not work for everyone. It can cause some brain fog initially when titrating up the dosage due to antagonism of different nicotinic acetylcholine receptors. And for some it just doesn't help, or causes adverse reactions, so YMMV.

Memantine is also an acetylcholine antagonist, and a serotonin receptor antagonist.... Not sure how this affects anything to be honest. And of course a dopamine D2 receptor agonist (we know how this helps)...

Other NMDA antagonists include; magnesium, zinc, DXM, ketamine, and huperzine A...

Hope that helps


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## The Professor (Jul 31, 2011)

crayzyMed said:


> Yes, they do block the underlying cause.


I mean, does it not allow downregulation?


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## The Professor (Jul 31, 2011)

hanzsolo said:


> Yes in my experience NMDA antagonists do correct the underlying cause - pre memantine, after 1-2 weeks on stimulants, the positive effects vanished and I was left feeling anxious, dazed, over stimulated and frazzled.
> 
> When I added wellbutrin and magnesium, it was better but I still had some tolerance related issues.
> 
> ...


Thanks. Will study this closer when I have more time.

Your last sentence, how does it help? its a D2 agonist, isn't adderall also a D2 agonist?


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## crayzyMed (Nov 2, 2006)

The Professor said:


> I mean, does it not allow downregulation?


Indeed, downregulation is slowed down a ton, breaks are still recommend tough.


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## hanzsolo (Jan 2, 2011)

Crayzy

Thanks for the info on D2 agonism, good to know. True that would be like requip and mirapex = not good... 

Have a great day all !!!!


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## The Professor (Jul 31, 2011)

hanzsolo said:


> Crayzy
> 
> Thanks for the info on D2 agonism, good to know. True that would be like requip and mirapex = not good...
> 
> Have a great day all !!!!


?


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## hanzsolo (Jan 2, 2011)

The Professor said:


> ?


Crazyz informed me and someone else (in another post) that D2 agonism is actually not a good thing;

As posted by crazy in relation to memantine "The D2 agonism is pretty non significant, wich actually as a good thing as they arent very great meds untill you have parkinson."

Upon further research, it seems D2 receptor agonist drugs such as mirapex are generally not well tolerated (for most). So it appears to be a good thing that mem d2 agonism is non significant...

Also I do not believe adderall is a D2 agonist....


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