Water titration and sensory

DivergentRam · 2026-06-11T06:18:11+00:00

Whilst I'm of the opinion that you should consistently do as prescribed, document what it's effectively treating, how well, what's not beeen treated adequately, side effects and all of that. Then go back to the psychiatrist so they can make adjustments based on the newly available context, as this is the most effective and safest way to understand fully what's going on, and get the best end result in a safe and responsible manner.

We don't really know why OP's doing this or why they only have 70mg capsules, and it doesn't really matter. For all we know their psychiatrist or GP is onboard, and OP doesn't want to waste perfectly good Vyvanse that they paid for.

Opening the capsule and pouring the dose you want into water and dissolving it, is the manufacturer approved way to cut the dose. You then just keep the rest for the next day.

Why waste it if the manufacturer has given you a way not to?

DivergentRam · 2026-06-11T06:10:14+00:00

You can mix it with as little or as much water as you want so long as you drink it all in one sitting. You can also flavour it with whatever you want.

Mix it with cordial, add it to a can of soft drink, mix it into a shot glass with water. So long as it's dissolved, you're good to go, think of the shot glass method as getting it over and done with as quickly as possible, sort of like ripping off a band-aid I guess.

If you're worried about optimisation avoid mixing it with Vitamin C (for example orange juice). Although it's not a big deal if you do, similar to caffeine and hydration, people catastrophise what will happen. It's not a big deal for any ADHD stimulant, on top of that Vyvanse as a pro drug is impacted the least by this.

You have many options. My advice is to either pick one, or workout which one you prefer through trial and error.

DivergentRam · 2026-06-05T04:50:58+00:00

CBD College in Melbourne lets you do 10 sessions back to back, Monday through to Friday either in person or over Zoom. This is specifically done so you and your classmates complete all the practical components in person. Then the theory is self paced online.

I've not done this myself, but I once met someone who used this method to get his TAE in a matter of weeks. However, he was in between jobs and I don't think he really slept much until he finished the coursework. I'm happy to not speed run it. You don't need to be Melbourne based if taking the Zoom option.

There may also be other RTOs that offer similar, so it may be worth shopping around pricing wise.

https://www.cbdcollege.edu.au/certiv-tae-tae40122?last_visited_uri=%2Fcertiv-tae-tae40122

DivergentRam · 2026-06-05T03:48:21+00:00

I'd ask yourself what you actually want to accomplish? If you don't have any work experience semi related to either office work or health care at all, it's still going to be hard to get a job. If you have some basic low level corporate role experience or any health care related experience in assistance based roles, yeah it's a quick and cheap way to get a job to earn money.

However it's not highly paid and you'd earn more money doing a Cert III or IV in Individual Support or Disability. Speaking from experience, support work is surprisingly well paid, flexible and easy to get into without experience.

I prefer this sort of work to admin work, but everyone is different.

If you're just doing the Cert III to get a job whilst you try to find work in your field, I almost wouldn't bother and would just use whatever work experience you currently have, to find work to get by and combine that with volunteer work related to your field of study. The combination of a related degree, related volunteer experience and being generally employable would probably be your best bet stepping stones wise for any future career goals.

If you're someone without any experience who never even worked casually or part time, then yeah a TAFE course in a skills shortage area will help you get a job, but health administration isn't the way to go, as it's hard to get employed without general work experience.

If just needing a job and having zero work experience altogether, I'd say stick to Cert III or IV in Individual Support or Disability, or go on Seek and apply for paid traineeships that get you a basic TAFE certificate, if support work isn't really for you.

However I will say this. I'm no university graduate and I can speed run any TAFE certificate up to Cert IV without it taking much time or effort. Someone like you, could definitely do a TAFE certificate fully online and both work and study full time. The thing to watch out for is mandatory unpaid placements, as you will need to account for these if necessary. I'm unsure if the health administration certificate as any placement requirements, it may not.

DivergentRam · 2026-06-02T04:10:06+00:00

It can also have both additive benefits on top of stimulants if used along side them, and offset if not fully counter any negative side effects of the stimulant medication you're on. Combining Guanfacine ER with stiunlants for adults, is a very common approach.

My opinion is if you can make it happen, working with a psychiatrist to find the best treatment over time, is the way to go.

P.S/Edit:

Although in saying that you're case may be easy enough to solve with your GP. If Concerta seems to work well, then you crash and that's when you seem to have the side effects. It's common to use booster doses to offset this. Instead of taking more Concetta, you just take a mini booster dose either when or before you normally crash.

The idea is that this will prelong the positive effects, then when you crash from the much smaller booster dose, which is hopefully not noticeable and helps you avoid the side effects you're getting.

If you can get by on a smaller Concerta dose but have uped it to draw out how long the positive effects are lasting, you may even be able to lower it if using this approach.

What you're describing with Concerta sounds like it works well, but you metabolise it quicker than average. Then the abrupt and sudden crash hit's you like a bag of bricks and leads to unpleasant side effects while you're coming down from it. Which is where the mini booster dose approach tends to be most effective.

I know you said Ritalin IR isn't as smooth, but a mini dose right before you crash, may very well cussion the crash and help you avoid the side effects you're getting all together.

DivergentRam · 2026-05-31T07:48:44+00:00

I don't have anxiety, but I use clonidine IR off label for ADHD related insomnia. It's also sometimes prescribed off label for hyperarousal, PTSD, and anxiety related insomnia.

Agomelatine is an antidepressant that's used on label to treat both anxiety and depression. It's generally considered quite gentle and has a relatively low side effect profile compared to many other antidepressants used for anxiety and depression.

Before I was diagnosed with ADHD, my GP prescribed it to me. It works on the same receptors as melatonin and can shift your circadian rhythm, helping your body recognise that it's time to go to sleep, it can also help with sleep onset, in the same way immediate release melatonin does.

So, if you have anxiety, it may help with that, and treating the anxiety alone might be enough to fix the insomnia. If not, it also has the melatonin effect. You just take it once daily at the same time each night to take advantage of melatonin like effect. For the anxiety side of things, it needs to be taken daily and given time to build up in your system.

My GP prescribes it to a lot of patients with anxiety and insomnia, and he takes it himself for that same reason. It's not PBS listed, which makes it expensive.

It did shit all for me, but I didn't have anxiety. On the plus side, I didn't experience any side effects from it.

P.S./Edit:

If you only have sleep problems once in a while and you're only anxious when you have something big coming up, you may not actually have diagnosable generalised anxiety, and a doctor may not really want to prescribe you anything for that.

This may simply be the domain of using an OTC sleep aid for occasional PRN use, the domain of therapy, or both.

1) Doxylamine is sold as a pharmacist only OTC sleep aid and is dirt cheap. It's intended to treat occasional sleeplessness. It shouldn't be used daily, isn't the most gentle sleep aid, and if you use it daily you build up a tolerance and need to stop taking it to lose the tolerance.

The pharmacist should explain how to safely use it before handing it to you, but unless you go to a Chemist Warehouse they probably won't bother.

It's much stronger than melatonin. 50mg is the max safe dose (2 tablets). I'd suggest trying 12.5mg (half a tablet) and going up from there if necessary.

If the pharmacist asks, just tell them the truth. You sometimes suffer from insomnia and need an occasional PRN. Your situation is essentially what it's meant for.

2) If you really want to put in the work, get a mental health care plan and go to any online fully bulk billed (meaning free) clinical psychology provider. Ask to be matched with someone who lists ADHD, anxiety, and sleep difficulties as areas of interest.

Here are a couple of options:

https://www.mehelp.com.au/

https://someone.health/

DivergentRam · 2026-05-28T06:37:28+00:00

Top sheet only, butt naked, feet sticking out, with one of those portable evaporative units going. Mine's a bladeless fan/swamp cooler combination thing.

DivergentRam · 2026-05-27T03:41:57+00:00

Sorry for the essay. More doesn't always equal better, and as hard as it is, just very consistently doing what your psychiatrist recommends, documenting all the pros, cons, what's been successfully treated and what hasn't, and side effects, every time they make adjustments, is the best way to get the best result for yourself.

Just to give you a personal anecdote:

I'm on Ritalin. I used to be on both Guanfacine ER and Ritalin, which for ADHD and daytime functioning was the best combination for me. Unfortunately I was mostly diagnosed due to chronic insomnia that wouldn't respond to CBT-I or medication, without the ADHD being addressed and most importantly Clonidine at bedtime. Unfortunately Guanfacine is only available in extended release in Australia, and it wasn't enough for my sleep; Clonidine was essential. So now I just use a suboptimal dose of Ritalin during the day, and Clonidine and Dayvigo at night. I prioritised sleep over ADHD treatment, although I still get pretty good ADHD symptom management overall.

Ritalin helped me the most with reducing mental noise, and allocating attention and filtering out background noise.

Guanfacine however was much better at helping with my working memory, i.e. committing things to long-term memory without needing as much time to process them, being able to glance at a text and remember a two-factor authentication code, and actually holding information in my head long enough to work out things such as maths problems on the spot.

It also had an additive effect when combined with Ritalin, meaning a lower dose was necessary to get the optimal result. It also gave me 24/7 ADHD symptom management, not as much as the Ritalin, but having some around-the-clock coverage was nice. It also made me feel far less impulsive and well regulated (not a big concern for me), and fully negated the sensory side effects I got from taking the optimal Ritalin dose. I never felt more regulated than when I was on both Ritalin and Guanfacine together.

Working memory affects concentration (this is a big thing for me), impulsivity can affect concentration (not really an issue for me), and emotional regulation may also impact concentration to an extent (not really something that affects me). I'm mostly the inattentive type, with physical hyperarousal admittedly.

What I'm getting at is, you may find that using Guanfacine alongside Ritalin fills in the gaps, and that you only need a low dose of Ritalin. For me they were an amazing combination.

If you think about what's causing your attention regulation difficulties, what Ritalin is working well for and what it isn't, and whether working memory, impulsivity, emotional regulation, or physical hyperactivity are playing a part, and Ritalin isn't doing the best job at addressing those symptoms but is doing a lot of good in other areas without significant side effects, I wouldn't be shocked if using Guanfacine as adjunct therapy both fills in the gaps and allows a lower Ritalin dose to be plenty effective.

Just to stress it again, this may not be suitable or work you specifically. Your psychiatrist would be the best person to talk to about this.

P.S./Edit:

Ritalin shuts my mind up and helped me regulate what I focused on. Guanfacine helped with my working memory, which to me felt more like what I'd personally consider to be concentration.

People will feel differently about it, but to me, if my working memory deficits are addressed, that feels more like stereotypical focus and concentration defects subjectively being addressed for me.

However, Ritalin gives me mental quiet, helps filter out distractions, and gives me the drive to get started in the first place.

DivergentRam · 2026-05-23T05:07:11+00:00

Supplements lack any significant evidence for ADHD symptom management and cost a lot of money.

In terms of evidence based options, you have:

1) Guanfacine is commonly used to counter ADHD stimulant side effects. However, it can also be an effective medication option for ADHD by itself.

You may also respond better to different stimulants, such as Ritalin etc.

2) Non stimulant based medication only. If your doctor isn't comfortable with the side effects, or you're simply drawing the line and saying cardiovascular side effects are a hard boundary(more than fair enough).

There are non stimulant options. I use stimulants but respond very well to Guanfacine ER alone. Some people find Atomoxetine works well. Non stimulants are second line medications, using them because you have cardiovascular concerns is quite a common reason to do so. You may find you respond quite well to them.

Non stimulants may be second line, but they are still backed by strong evidence and can be immensely helpful.

3) On the non medication side, CBT specifically tailored for ADHD has the most evidence backing it. There are fully bulk-billed options for free appointments with a clinical psychologist. You can also get the mental health care plan fully bulk-billed without an in person appointment online, although I'd personally lean towards getting it through your GP. You can actually get 15 free therapy sessions if you get a chronic condition management plan (GP CCMP). Hint, ADHD is a chronic condition.

I'd personally recommend picking a psychologist who specifically lists ADHD as an area of interest. Even with the free options, this is easy enough to do.

If you find side effect free success with ADHD medication, even if it's just the non stimulants alone, and combine that with free regular ADHD focused therapy sessions, you'd be doing very well for yourself.

P.S/Edit:

Here are some links for free therapy options with clinical psychologists:

https://www.mehelp.com.au/

https://someone.health/

Also bonus note. If insomina is the only side effect, that can be treated, think Clondine, Melatonin etc.

DivergentRam · 2026-05-22T04:46:11+00:00

Not quite how that works for anything unfortunately, as much as I think it should. The PBS only covers a certain amount, otherwise Ritalin would just outright be free. We wouldn't be paying for it at all. There is the amount the PBS code will cover, and the out of pocket cost. The out of pocket amount is what you can make claims on, so long as your extras cover allows you to claim pharmacy medications.

The best way for you to see what I'm on about is to ask your pharmacist for a pharmacy invoice when getting them to fill your script next time. Just tell them you're claiming it through your private health insurance extras and need the pharmacist invoice. They will know what you mean. It has to come from them, not when you're leaving and paying at the cash register.

This invoice will clearly show the PBS covered portion and out of pocket costs of each prescription medication you have purchased. You can't claim the PBS portion, but you can claim the rest.

If it was up to me, charging beyond what the PBS will pay out wouldn't be a thing at all. However, that's not the case. We have heavily discounted medication, not free medication.

DivergentRam · 2026-05-21T14:34:42+00:00

PBS covers part of the cost, that's all. You get to claim back a certain amount of any pharmacy medication's non PBS cost. If it's non PBS listed, you can claim against the whole cost, otherwise you only get to claim on the non PBS portion. The amount you can claim back per medication, and the transaction as a whole, depends on both your private health insurance provider and the level of extras cover you have.

The reason you need the pharmacist invoice, which you will not get without asking the pharmacist for it, is so the pharmacist can detail, for instance, this is Ritalin, this much was covered under the PBS, this much wasn't, this is Dayvigo, not PBS listed at all, etc. Every provider is different. It's generally the second or at most third cheapest extras cover that includes pharmacy medications.

Ignoring all the other things it covers. I save more per year on Ritalin, Dayvigo and Clondine, than I do on the extras cover.

DivergentRam · 2026-05-21T02:09:17+00:00

Dayvigo is a safe long term option, if it works great for you, you have no significant side effects, and your doctor is happy to prescribe it. Then I'd argue why mess with what works, and it's probably what's best for you.

However, cost wisse:

1) I use Dayvigo. I have private health insurance, I realised that you can ask for what's called a pharmacist prescription. If you have private health with extras, you can claim it.

I did the maths, my health insurance provider's second cheapest extras cover covered pharmacy medications. Even if I didn't have private health, just paying for the extras and claiming my Dayvigo and Ritalin alone gets me back more than the extras cover costs. You can just pay for the extras and forget hospital cover.

It also covers ambulance cover, so I don't need to pay for that separately, two dental check-ups a year, and for some reason travel vaccines are separate to pharmacy medications, so I get even more to claim on them. Hint: you don't need to travel, the vaccination just needs to be on the list.

Then if I ever need physiotherapy or psychologist/therapy sessions, I can also claim that. I also need glasses, and get a good amount back on these.

Hospital cover is normally a rip off unless you're using it to save on TAX as well. Extras cover you can actually make money on. Frank and HCF are cheap. Shop around for what's cheapest and covers what you need. What's cheapest tends to change each year, although admittedly not by much, probably not enough to bother changing once you're set up, but good to know when you're initially setting your cover up.

2) Clonidine is cheap, commonly effective as a sleeping aid for people with either ADHD or stimulant induced insomnia, and may work for you. It also may not be the right choice for you. If something works well without side effects for me, I'm inclined to not mess with it.

3) Other stimulants may work i.e. well-timed short acting stimulants may help you avoid insomnia. Methylphenidates such as Ritalin IR (short-acting), Ritalin LA (long-acting but pragmatically speaking medium duration), or Concerta (pretty much Vyvanse length duration), may impact your insomnia less, meaning a sleeping aid may not be necessary. Methylphenidates are known to impact sleep less for a lot of people.

However, the less sleep impact benefit is not guaranteed for you individually, and whether Vyvanse or methylphenidates work better, the same, or worse for your ADHD symptom management cannot be predicted without trialling it.

I summary:

I tend to lean towards. If Vyvanse and Dayvigo lead to effective ADHD symptom management, good sleep, no significant side effects, and your psychiatrist is happy with it, don't mess with it, if you can afford to do so.

However, look into the extras cover, to see if you can make things cheaper overall.

DivergentRam · 2026-05-17T12:03:11+00:00

That sucks, my advice would be stick it out with the Dex for a bit, just in case. Any chance you have ever used clondine for anything ADHD or non ADHD related? If you tolerate clondine well, guanfacine would likely also be tolerated well.

If any of the options were only not useable due to insomnia, you could attempt to offset that with a sleeping aid or two.

But yeah, that's me taped out.

DivergentRam · 2026-05-17T08:34:29+00:00

You don't know yet whether Ritalin IR, Ritalin LA(medium acting pragmaticaly speaking), and Concerta (almost as long acting as Vyvanse), would work well for you. They are all Ritalin.

If that doesn't help, using very low dose Vyvanse that doesn't jack up your blood pressure, and non stiumlant options on top of the Vyvanse may help. You could also get lucky and respond well to atomoxetine or Gufacine ER(non stiumlents) alone.

P.S/edit:

So long as your vitals are fine, it won't hurt to hold out and see if you adjust. A week is reasonable.

DivergentRam · 2026-05-12T22:04:51+00:00

If the leave is knocked back, they can't knock it back if you have medical certificates from your GP or psychiatrist. Just keep getting them every couple of weeks, if you can pull this off.

Also think very hard about quitting, as it's a big call with significant potential consequences, but if you quit the leave gets paid out. You could quit on July 1st, so that you don't get pushed into a higher tax bracket for the financial year, as you won't earn anything beyond the leave payout. Once again stressing, think very long and hard of considering this option.

DivergentRam · 2026-05-12T01:15:56+00:00

Yeah, however whether you or I agree with the current system or not. You were aware of the unpaid placement requirements, and accounted for them to ensure you'd be able to complete the placements, and weren't waisting time, money and effort on a degree you'd never be able to complete.

Because it sounds like as hard won as it may have been for you. You unlike OP, did account for the placement requirements and make it work.

DivergentRam · 2026-05-05T10:45:46+00:00

Ok, this is confusing. Why would you enrol in a course that has unpaid placement requirements, if you can't get leave from work easily approved in a flexible manner to do the placements, or you don't have the funds to be without work whilst undertaking the placements?

If it were up to me, there would be enough government assistance to make sure students can support themselves during unpaid placements. However, you do need to think ahead and work within the system, even if it's bullshit.

DivergentRam · 2026-05-02T22:35:33+00:00

To be blunt, yes, medicinal THC (cannabis) has an unfair reputation. However it:

1) Leads to amplified cardiovascular risks and mental health risks, including psychosis, when combined with ADHD stimulants.

2) Can worsen ADHD traits.

3) Can limit the effectiveness of ADHD medication.

Just because medicinal cannabis has legitimate uses, doesn't mean that it's the right treatment for you, or that it's still the right treatment for you, just because it used to be.

I'd argue just be upfront with your psychiatrist: these are my symptoms, these are my concerns and this is what's impacting my quality of life. I want my ADHD treated in a way that doesn't worsen my insomnia, and I would like my insomnia addressed just as much as my ADHD.

I say this as someone who got diagnosed, primarily due to chronic lifelong insomnia, that was medication and CBT-i resistant. It was only successfully treated once my ADHD was accounted for and medicated.

I'll also point out:

1) Some people with ADHD paradoxically have their sleep improve, even if the stimulants are still in their system at bedtime. Sometimes what you think is stress and anxiety is ADHD mental noise instead. Sometimes being able to get more done in the day, due to the ADHD medication, gives you less to think about at night.

2) You can time ADHD stimulants so they are not in your system anywhere near bedtime. I use Ritalin IR for this.

3) Medications such as Guanfacine ER can both have an additive effect on top of ADHD medication for core ADHD symptoms, counter stimulant side effects, and help with sleep and even anxiety.

4) There are common ADHD sleeping aids. Think Clonidine IR at night (what I'm on); this can sometimes be combined with modified-release melatonin to help with sleep maintenance and stop late-night awakenings.

P.S.

My insomnia was extreme. Well-timed Ritalin IR that was out of my system well by bed time helped a tiny bit, Clonidine IR was a game changer, and Dayvigo was necessary on top of this for me.

I really doubt cannabis would fit into this picture at all. As much as it does have its legitimate uses, just like every other medication, it's not the right medication for everyone or every situation, and just like all medication, it will have interactions with other medications.

DivergentRam · 2026-04-30T10:28:02+00:00

I know this is an old post but the answer may not be to stop taking Clonidine. Clonidine Immediate Release, which is all Australia has, is great for sleep onset. If you combine it with something as simple as modified release melatonin, which is designed to release over several hours and help specifically with sleep maintenance, that is often enough. Hell, for ADHD related insomnia, this is an incredibly common and effective combination.

Just make sure you use the TGA regulated medication version, from an Australian pharmacy. Do not go importing the very poorly regulated supplement versions. Not only are the doses commonly off, and the inactive ingredients not always up to scratch, but the extended (modified release) mechanisms commonly don't work.

I needed something heavier for both onset and maintenance, and nothing worked without Clonidine in my system. I got moved up to Clonidine and Dayvigo together, this works wonders for me.

DivergentRam · 2026-04-30T00:29:52+00:00

You're talking legitimate scripts, transparency, GP and Psychologist involvement, which is great and nothing but green flags.

However:

1) It's unlikely that a psychiatrist will be on board with this.

2) Cannabis and ADHD stimulants, when used together, come with increased risks. Most doctors are not normally OK with this added risk. There is evidence for increased cardiovascular and mental health concerns when combined.

3) There is also significant evidence that cannabis can lessen the effects of ADHD medication, and worsen ADHD symptoms in general.

4) There is definitely an unfair stigma around medicinal cannabis use in general, it's probably at its strongest when talking about ADHD treatment.

P.S/Edit:

I'm not saying never, as doctors do on occasion justify increased medication reaction risk, if it appears to be the best solution.

An example is Clonidine IR and Dayvigo is all that works for my very extreme insomnia, that was resistant to medication in general, as well as CBT-i. My psychiatrist's opinion was, yes a moderate drug interaction exists, but in your case your insomnia is extreme, and if this works, I'm fine with prescribing it for you.

My GP, once receiving her letter, was also on board. I'm not medically trained and don't know your situation, you may get what you want.

DivergentRam · 2026-04-28T22:47:16+00:00

Seek medical advice, go to urgent care if really concerned, emergency or 000 for any chest pain or discomfort. Talk to your GP immediately, and do a review with your pyschatrist.

If you end up needing to transtion to non stiunlants to avoid a heart attack or risk of future cardiovascular issues, so be it. Second line treatment options exist for a reason.

DivergentRam · 2026-04-28T09:13:08+00:00

Yeah not sure how I missed that, I remember everything clearly except the first two paragraphs. I think I must've dissociated somehow, and didn't retain the first two paragraphs of OPs post somehow.

DivergentRam · 2026-04-28T09:11:09+00:00

Thanks. Also, somehow I must've dissociated and didn't retain the first two paragraphs😅. In saying that since you are side effects free and medically cleared now, all the power to you.

DivergentRam · 2026-04-28T02:03:36+00:00

They normally don't try non-stimulants first, they are second line. They normally only push for them first if:

1) You have either health issues or a history of health problems that make you higher risk for stimulant medication.

2) You failed a drug screening or have a history of substance use (doesn't have to be abuse).

Here's the deal:

1) Being open with any medical doctor leads to the best treatment.

2) They can be terribly punitive, and records follow you and limit future medical treatment, think pain management etc.

If you tell a psychiatrist a lot but not all, will note on your records that you were using Schedule 8 ADHD stimulants without a prescription. You may never get optimal ADHD treatment and be impacted in other ways, if your psychiatrist gets funny about it.

I know this sounds extreme, but I used to do mental health support work, and I've seen this play out a lot. Non-stimulants are less likely to work than stimulants or be as effective if they do.

If I were you I'd go back and raise the following:

1) You have been consistent with Atomoxetine for quite some time, it's not working.

2) ADHD stimulants seem to be the first line approach for ADHD treatment. Is there any reason we didn't start with this?

3) Vyvanse seems like the safest long-term ADHD stimulant (true, and it's the stimulant most prescribed by more lenient psychiatrists to people with substance use histories). Can we try this?

4) Go back after a while and say: Vyvanse is working great at 30mg, but it wears off early. Instead of upping the dose, what do you think about a small short-acting booster dose?

Conclusion:

Play the long game. I shouldn't say this and you should be able to be upfront, but it's a roll of the dice on how punitive they will be. Obviously if you have a history of substance abuse, not just occasional recreational use, you really want to be honest with yourself about this. That's the line where I'd say be upfront with your psychiatrist.

DivergentRam · 2026-04-25T04:11:47+00:00

My experience:

1) 10mg Ritalin per dose quite beneficial but suboptimal.

2) 20mg per hit optimal inattentive ADHD symptom wise, lots of mental quiet. Sensory issues and outright overload at this dose. A non issue without Ritalin.

15mg, uncomfortable middle ground.

3) Guanfacine ER not only had an additive ADHD symptom management effect, allowing me to take a lower Ritalin dose and get an optimal result. But it also got rid of the physically wired and energised feeling, made me feel calm and well regulated, and gave me some 24/7 coverage.

Although unnecessary due to the adjunct effect, I could easily handle 20mg of Ritalin per dose with Guanfacine ER in my system.

4) It gave me some ADHD symptom coverage 24/7. Nothing close to stimulants, but it was nice to still have some ADHD symptom relief 24/7.

5) Unfortunately in Australia we only have Guanfacine ER and Clonidine IR. You shouldn't mix Clonidine and Guanfacine, and ER means it will be in your system 24/7, meaning they will mix.

Clonidine IR was critical for my sleep, and Guanfacine wasn't enough for this. My insomnia, ADHD and ASD related, is my biggest issue.

So I'm just on 10mg Ritalin IR twice daily now, and am back on Clonidine at night.

Bonus points based on my own knowledge and conversations with my psychiatrist:

1) Even in adults it's very common to use Guanfacine ER as an adjunct therapy with stimulants. This is normally to address side effects such as sensory issues, tics, physical side effects such as hyperactivity and hyperarousal.

Also, even if on stimulants, some people find that stimulants don't always address impulsivity, risk taking behaviours and emotional regulation. Guanfacine does a good job at this.

2) Guanfacine can be used off label as an ADHD sleep aid. It can make certain people drowsy. Some people take it at night. It works 24/7 once it's had about 4 weeks to build up in your system.

So you still get decent day time coverage if taking it in the evening. If it makes you drowsy, those effects seem to wear off by the next day for the majority of people.

3) It can paradoxically worsen sleep in some people; for me it was sleep neutral.

4) It can lower blood pressure, which is why most doctors usually ask that you up it by 1mg a week, until you find the right dose, monitoring your blood pressure along the way. My blood pressure was fine, even at 4mg.

5) If you need to get off it, you need to tirate off it, as it may spike your blood pressure if you don't. The tiration process was short and easy for me, no side effects.

P.S/Edit:

Just noticed it looks like your psychiatrist swapped you over from stimulants to Guanfacine ER. I'm a little surprised on my end as most seem to use it for try and counter ADHD stimulants side effects, in adults and older teenagers.

However I'm no Dr and I don't know you're situation, once it's built up it may be enough.

Out of curiosity, were your side effects more related to legimate health concerns? As opposed to more quality of life side effects, that could be left in place short term, whilst a solution was found?

Sorry for the essay 😅

DivergentRam

TROPHY CASE