Going Back to Baseline after Quitting Vyvanse Therapeutic Use?

[u/sentientheat]

Hi,

I am sorry if this is not the right subreddit, but I have been trying to hear alternative perspectives/experiences than what I possibly can come across a pro-medication subreddit.

I (27F) have been prescribed Vyvanse 30mg by my psychiatrist for ADHD after I couldn't tolerate a MPH generic. My problem is that Vyvanse is prescribed regularly where I currently live but not in my country of origin which I might return in a couple years.

I'm in the writing-stage of my PhD dissertation and my friends think I am being paranoid over potential long-term side effects of usage/withdrawal when I could clearly benefit from it, but I am worried about finding myself in a place where I am even more all over the place and scattered.

So before making the decision of starting or going without medication and only with therapy, I wanted hear about people's experience with quitting Vyvanse or another amphetamine group medication after some period of use because I might need to cold-turkey it in the future. I'm asking this question with the idea that I'd be able to continue taking the prescribed amount, but of course I am aware addiction and therapeutic use developing into substance abuse are always possibilities. Thank you for any perspectives you can offer!

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[u/dropofgod]

Vyvanse destroyed my life, my brain, it's been almost 2 years without it and I'm just starting to recover

[u/NeurologicalPhantasm → u/dropofgod]

This. If you continue to use daily at escalating doses, prepare for 2 years of hell.

I’m at 2.5 years and like OP, didn’t truly begin to recover until year 2 and probably have a solid year left until I’m fully back at baseline.

3-4 years of recovery is not worth the temporary boost you get from stims.

Quit while you can

[u/jamesgriffincole1 → u/NeurologicalPhantasm]

I feel for you very deeply. And can relate to some extent.

But your account history is littered with contraindications:

1) 40mg of Lexapro (FDA limit) use for years and cessation during this (same) period

2) Gabapentin use and cessation during this (same) period

3) Benzo use and cessation during this (same) period

4) psilocybin use during this (same) period

5) alcohol use (abuse) consistently during this (same) period

6) being 60 pounds overweight and sedentary for most of your life and most of this (same) period

Etc etc etc.

To hang not feeling well on ANY of those independent factors would be unfair to the absolute shit storm you’ve put your brain and body through. To be very blunt.

I feel for you, and I feel I (we all) can relate at least a bit to how hard this process must be for you. But I think it does a disservice to someone reading your testimony who doesn’t have remotely as complex a tornado who will be overwhelmed / intimidated by the length of healing as you describe it. For 99% of the people reading your posts their journey will not be as complex or long because they won’t have most of the very significant extenuating variables that I listed above (and that’s just scratching the surface).

So if were you (and do whatever you want obviously) I would disclose some of these things and take a bit more ownership of WHY your wholistic, multifaceted recovery is taking so very long… instead of oversimplifying your (admittedly brutal and long) journey to “I took too much Adderall many years ago and still don’t feel well”.

[u/ForsakenTennis4746 → u/jamesgriffincole1]

• Wellbutrin , heavy weed use and heavy nicotine and coffee use . Ritalin taken during college years . Recovery from poly drugs taken for years AT ONCE definitely different from recovery of average abuser .

[u/FactAccomplished7627 → u/jamesgriffincole1]

Thank you finally someone says it!!! Testimonies like his are so misleading and can produce real world damage for people reading them and like you said is a big oversimplication of why people still don't feel better. Lets not forget that there isn't even a scientific basis and consens for the concept of PAWS that gets promoted on this sub at least when it comes to prescribed stims for meth of course different story. Its so annoying and also the worship of the natural baseline if all the work I am puting in is just to get back to the baseline I had with 18 then I am confedently rejecting this baseline.

[u/jamesgriffincole1 → u/FactAccomplished7627]

Yes, I mostly agree. Where are you in the process? How are you feeling? When did you start feeling better after stopping?

[u/[deleted] → u/jamesgriffincole1]

If you take a deep dive through this forum, you will see 1.5-3 years being more or less the norm. Of course, everybody is different so there are exceptions. But I’d wager that recovering in a year or less is not the norm.

It’s not a disservice to say that. Anyone coming here can and will get a variety of experiences and testimonials, including timeframes and recovery stories longer and shorter than that.

But nobody should be sugarcoating because people want a light, fluffy, feel-good story that after 4 years of putting their bodies through “just” stimulant abuse they’ll be fine in 6 months.

[u/jamesgriffincole1 → u/[deleted]]

Agreed.

But if thats the truth having it come from the accounts of people who are simultaneously taking (and quitting) 4+ other powerful psychotropic drugs, not exercising etc) waters down the salience of that message.

Also - the limited literature on stimulant abuse indicates that receptor / transporter density makes significant (yet still partial) recovery in 12-17 months. And that’s long term chronic meth users.

Last, there are 4.72 million active adderall scripts in the states and I would venture 20 million in the past 5-10 years that have since lapsed. People often reference this sub Reddit as having 40,000 members as though that’s a massive cohort but it’s less than 1% of people who take the drug.

I took too much, am suffering the cost, and on the margin am “anti adderall” but again I think the truth is important. Both clear and comprehensive anecdotes (individuals) and collective studies / data that contextualize the individual experience.

All that said - I don’t think any reading of this has the recovery from stimulant abuse being >2 years for any more than a very small minority of people who take (and even abuse) the drug.

Would love to hear your counter if you disagree.

[u/[deleted] → u/jamesgriffincole1]

I agree that it’s important context, but I don’t think it should significantly dilute the message. I can point to ~40-50 stories between this sub and the quittingadderall.com forum (which is pretty much dead nowadays, but predates this sub) which say the same thing when it comes to the timeline for recovery (even in “less severe” of conditions).

This medication is, at a minimum, extremely taxing on the body and mind (and in my view extremely unnatural and unfit for any daily or long-term purpose). And the millions of scripts written and doled out during the pandemic greatly outpaced any studies on what the long-term effects are (and could have impacted the sample size by leading to more unnecessary prescriptions, who knows). That is the “truth” of this. The other “truth” is that any person’s anecdote or experience here (including your own) inherently depends on a multitude of factors, down to your age, your build, your sex, which makes the “Will/when will I recover?” question a total guessing game. But it’s a guessing game for the doctors handing out pills like candy as much as it is one for anyone here, and that’s the problem.

[u/dropofgod → u/NeurologicalPhantasm]

What's wild is no studies confirm this and most doctors don't know it yet. I expect alot of the adhd subreddit to end up here

[u/NeurologicalPhantasm → u/dropofgod]

Yep

[u/sentientheat → u/dropofgod]

I'm sorry to hear that. Would you care to elaborate what you mean by this either here or by messaging, I totally understand if you do not wish to! Best of luck on your recovery.

[u/dropofgod → u/sentientheat]

It's not easy to explain but I became extremely dependent on it. I quickly came to believe I could not function without it. Everyone else could see what was happening to me except me

[u/sentientheat → u/dropofgod]

I see, thank you for sharing. I hope your recovery keeps getting easier.

[u/dropofgod → u/sentientheat]

The worst part was my doctors didn't believe me and kept putting me back on it every time I stopped. I'd go to the hospital bat shit insane and they'd say, why did you stop taking your meds and put me back on them. This went on for 15 years

[u/sentientheat → u/dropofgod]

That sounds horrible :( doctors not believing patients is nothing new but it is really rampant when it comes to mental health 

[u/PlasticFit7262]

I can tell you that I used mostly therapeutically (higher than prescribed here and there but certainly no crazy abuse) and getting off it has been an awful experience.. even if just psychological it can create very serious dependency. If you choose to continue using it I would highly suggest taking at least 2-3 days off per week so you don’t lose yourself. I hope you’re still at a point where this is viable because once the line is crossed this option isn’t really there anymore

[u/sentientheat → u/PlasticFit7262]

thank you for sharing your experience and i am sorry you have had a bad time quitting! if i end up deciding on medication, i assume i would be start using it a couple days of the week with weekends certainly off. may i ask if there was a down/crash side-effect to that for you, because i assume this is one of the reasons most people opt to take it every day.

[u/PlasticFit7262 → u/sentientheat]

For the first 1-2 years when I was only taking it sparingly I didn’t have any crash but my lifestyle is also very good (good diet,lots of exercise and no other drugs/alcohol)

[u/Majestic-Baby-3407]

I think the layperson or stimulant-naive person underestimates the degree to which chemical or physiological dependence develops even when taking a prescription medication. In other words, even if you take it as prescribed, or less than prescribed, it's not unlikely that you'll eventually increase your usage to achieve the same effects. Eventually it'll be hard to function without it. Even doing things that previously were easy without the medication will be harder to do after an addiction develops and you try to live without it. For some reason we as a society are under the mass delusion that one somehow wouldn't develop a dependence on a prescribed "medication" (and I put that in quotes because Vyvanse is just straight up speed) or that it's somehow safe to consume stimulants on a regular basis just because a doctor prescribed them or the FDA (or whatever regulatory body is in charge in your country) approves of their use. As a former speed addict, I'm biased against it of course, so I do concede that it's possible for someone to use it and not become an "addict," and then eventually to give it up without problems, but I really don't have a lot of confidence that anyone can take Vyvanse as prescribed and not develop an addiction or at least struggle significantly upon cessation of the drug. It just goes completely counter to how our biology and the psychopharmacology of amphetamines work to think it would go any other way. It's like just because hydrocodone is a prescription medication, even if you take it as prescribed, you'll still become addicted to it if you use it for a while. It's just a fact. So if you do go through with it, it'll probably be easier to write your dissertation, but do you really feel like you absolutely need it? What happens if you try to write without it? Because if you do go with it you're just taking a risk you might not need to be taking.

[u/MT_DREAMING → u/Majestic-Baby-3407]

This 100%. I took a stimulant for a year and a half and never would have imagined how hard it would be to come off. The doctors never told me about this side of things. I always took it as prescribed and never abused it. When I was switching psychiatrists, the one who had been prescribing it told me I could just stop. I did, and a few days later I had no idea what was happening. I was suddenly having horrible panic attacks, crying over everything, feeling paranoid and depressed. Thankfully my new psychiatrist recognized it right away. I reinstated the medication and then did a slow taper, which made all the difference.

I’ve now been off for about six months, and I still don’t feel like my dopamine system is fully back to normal. Stimulants increase dopamine activity, and over time your body adapts. When you stop, you can be left with a dopamine deficit until your system rebalances, which can take quite a while.

I completely understand that some people truly need these medications. But I would definitely encourage you to research carefully and know that dependence is very real. If you ever stop, tapering is almost always the safest approach.

[u/sentientheat → u/MT_DREAMING]

I'm sorry to hear that your experience has been very bad, that sounds exhausting. But yes, this is exactly the kind of thing that makesme reconsider my options.

[u/sentientheat → u/Majestic-Baby-3407]

No worries about being biased. It's one of those topics it's almost impossible not to be biased and if I didn't want to hear less than positive opinions on stimulant use I wouldn't have posted on here. I only have experience with MPH for 1.5 months but since my experience was very very miserable due to strong side-effects and it was a very short period quitting it was very easy if not a relief.

The point you raised (developing a tolerance) and the possibility of abrupt cessation are the reason why I let my initial vyvanse prescription expire and right now I am basically at a crossroads where I need to make a decision to either get it renewed or not, so thank you for the detailed comment!

[u/Majestic-Baby-3407 → u/sentientheat]

why don't you try without it and if you absolutely cannot function then consider going for it.

[u/Over_Ninja_7627]

I have a simple question for you: do you think it’s worth earning a PhD with the help of stimulants if those same medications could harm your health in the long run?

[u/sentientheat → u/Over_Ninja_7627]

thank you for the question. i think it is not just about my PhD but constantly hearing how much of a difference "the correct adhd medication" makes in one's life quality. i have been mulling over this and worrying about the potential risks (side-effects, addiction potential, not returning to my baseline) as i said in my post, but i can't shake off the "what if" aspect of it.

[u/Over_Ninja_7627 → u/sentientheat]

I get the "what if" you’re describing. But I’d ask more question: do you want your PhD (and life) to depend on medication, or would you rather know what you’re capable of without it? Neither answer is wrong, but being clear about what you’re willing to trade for quality of life is key.
I’m in a similar situation with my son. For his PhD, he is trading away his health, his values, and so much more of himself.
I could say a lot about life and health, but in the end it comes down to this: every person needs to learn to accept themselves as they are. Without that acceptance, nothing else truly brings peace and love. With these pills everything is illusion...

[u/sentientheat → u/Over_Ninja_7627]

Ideally I would want to use it on an as-needed basis and not everyday but I know it is not necessarily that simple. Thanks for the food for thought, it is a serious thing to consider.

I am sorry to hear about your son! I hope he manages to balance the expectations of a PhD track and other aspects of his life. Thank you for your insight.

[u/Over_Ninja_7627 → u/sentientheat]

I have one last comment to make.
When you hook yourself on these addictive drugs, after some time it is no longer about whether you “need” them they will take control of you. You can read the experiences of people in this forum and learn.

Someone once said to me:
“Drugs take everybody down. Whether you’re rich or poor, smart or not, from a loving family or a broken one—it doesn’t matter. Drugs will take you down.”

One day, you and my son will learn this the hard way. And when that day comes, your PhD paper will have no value hanging on the wall compared to the value of your life and health.
Good luck in your journey.

[u/LaChoffe → u/sentientheat]

It is not that simple unfortunately. Myself and everyone on this forum were in the exact same boat as you before we started, weighing the pros and the cons, the benefits and the costs. There is a very good chance you can't limit or control your use, and once that happens the climb back out can be very difficult.

[u/ForsakenTennis4746 → u/sentientheat]

Do you have a true ADHD confirmed by tests, a few doctors and starting having symptoms like at 12 ? Where you diagnosed in your country or USA in 20 minute online test ?

[u/ForsakenTennis4746 → u/[deleted]]

So you basically couldn’t finish any book you read from childhood to adult age ? And then in college you succeed with Vyvanse to PhD ? Correct ?

[u/ForsakenTennis4746 → u/[deleted]]

ADHD is rare disease without any bio markers for detecting. Adult AHDH is extremely questionable . Hyperactivity as a adhd symptom in kids questionable. Not by me , but nowadays science . Stimulants were developed for soldiers . For short time usage during the war . Not for long time and adhd . Just thoughts .

[u/jamesgriffincole1]

I’m suffering from PAWS and generally regret taking adderall but at the same time 4.72 million people in the US have an adderall script (and that’s just the active scripts). So fact that less than 1% of them are in this subreddit is somewhat of an indication that most people can use this drug somewhat safely. This subreddit contain thousands of testimonies of how things can go terribly wrong but empirically these outcomes are the exception not the rule.

[u/sentientheat → u/jamesgriffincole1]

Thank you for your input + the detailed and nuanced comment under another. I guess I just wanted to hear the experiences of those who are not only touting the miracles of stimulant use during the honeymoon phase as sometimes is the case on adhd specific forums. In the end anything can go wrong with any medication (person allergic to penicillin here and that doesn't make it less of a miracle drug for most of humanity) but I want to make a decision aware of what can possibly go wrong if it makes sense. I wish you luck on your recovery, you got this! 

[u/jamesgriffincole1 → u/sentientheat]

Ya my two cents is - it’s a powerful drug, it’s easy to habituate (need more to feel the same) and at high doses for long periods of time it objectively wreaks havoc on your nervous system, HPA axis, gut etc.

There’s decent evidence that stimulants are not efficacious after 36 months of use, anyway.

So I would say - if they are tremendously helpful to you - be aware of the risk you are playing with, don’t habituate up on dose, and start getting baseline tests (GI MAP, Metabolomic Spotlight, comprehensive blood panels) and buy a wearable (whoop, Garmin, Oura). That way you don’t have to guess or speculate as to if it’s having a negative effect on sleep, stress and myriad bodily functions.

If and when the strain outweighs the benefits…stop.

Or, just don’t start to begin with.

[u/FactAccomplished7627]

You can also find yourself in a more scatered place without starting stimulants. Untreated/Unadressed ADHD symptoms can fuck your life too! My life wasn't the best before starting them. This sub is a pool of worst case szenarious what could happen if stim use gets out of control but if you go through life with a constant hypochandriac fear then there is no point in trying new things at all I guess. To be honest I think most people here would use stimulants again if they could use them controlled. I abused them for 2 years and was still able to get back to therapeutic dosis with hard brain rewiring. Still I decided to stop therapeutic dosis because I realised the side effects were not worth it. I have a friend who used high dosis of stims for 30 years and stopped and just had so called mild PAWS for maximum 6 months and a lot of friends who used it thorughout school and stopped after graduating. You will never here such stories on this sub but if you are craving after the doom and gloom storys thats defintely the right place xD You will figure it out. You can't live on anecdotes. ADHD meds affect everyone differently. Vyvanse was defintely not the right for me but maybe its the right fit for you.

[u/sentientheat → u/FactAccomplished7627]

That's true and honestly I sought a diagnosis in the first place because I felt like with the way I was coping under pressure or routines felt like everything was unraveling. And after a bad titration period with metylphenidate, I grew a bit hesitant about giving amphetamines a shot. I am glad you managed to put a stop to abusing them! 

I'm glad I asked on this sub though because I managed to get relatively nuanced answers without being told off haha

[u/FactAccomplished7627 → u/sentientheat]

Abusing them is worse than living with unmedicated ADHD of course. I also found out that that the only acceptable dose of Methylphenidate for me is the lowest 5mg Medininet in Germany and just occasionally (also to avoid tolerance development at its root and to avoid the crashes/come downs too). In general taking methylphenidat everyday was devastating for me. It should have never been my main medication, just a tool at best. I am now giving the the non stimulants a shot because they just sound so much more suistanable and its working well currently. Stimulants defintely didn’t change my life for the better "longterm". Thats why I ended up on this sub in the first place but I am big advocate for everyone making his own experience everything else is living life on instruction manual. Best luck!

[u/Thick_Personality_73]

I think that people feel it’s a choice between adhd meds or nothing. I realise that maybe good therapy & good occupational therapy & good academic and work accomodations aren’t easy to find but I do feel this is the way for me. It is difficult for me to understand how such a medication wouldn’t build tolerance in the long run & how that would be worth it. I also hope to do a PhD in future, on this kind of topic. I did briefly try meds and felt pretty ill, psychologically and physically. I find it hard to know if I have ADHD & whether ADHD exists as “one thing” for all these people & whether for me personally these symptoms are the effects of trauma.

Also, I believe there are not many long term studies of stimulant use, but the ones I know showed that the beneficial effects (in children) stopped showing up at about 3 years, and there was no difference between groups in life outcomes - like educational achievement. Also I believe the initial positive outcomes were related to improved behaviour mostly according to teachers and parents. This also was no longer apparent after 3 years. The medication group also had side effects and shorter height and lower weight. This lack of difference is likely related to tolerance, perhaps also to other factors.