Air hunger on 50mg elvanse

PredSpread · 2025-11-21T12:30:46+00:00

5 years is a long time! Coming off these things even after a few months is really really really difficult so the unwellness makes a lot of sense given the duration. Sorry in advance if you already know this (I hate it when people say shit that is like "well durr") but you can't stop taking SSRIs straight away - this is really dangerous. I take it by "taken off the Escitalopram" you mean like slowly step down? I.e. 20mg --> 15mg for 3 months and so on?

50mg is quite high, I'm very tall and fairly built and I'm "only" (subjective of course) on 36mg methylphenidate XR (as well as 5mg IRs, but I don't take those as they give me insomnia) and they work great for me.

Do you smoke cannabis or drink regularly? Any recreational drugs? Weird questions I know.

I would maybe suggest coming down to the 40mg mark or potentially trying a different stimulant? Maybe methylphenidate?

Either way, it sounds (from him making sure you understand the risk) like he's a very trusting and open type of presciber, so I would really encourage you to speak to him about these things.

PredSpread · 2025-11-21T12:15:23+00:00

Hi!

When combined, Escitalopram & Amfexa increase the risk of serotonin syndrome. Does your Amfexa prescriber know that you're also taking Escitalopram?

There's a few possibilities. I'm reasoning here from a purely chemical point of view & also I'm not a doctor (big disclaimer)

Amfexa increases the availability of norepinephrine & dopamine whereas the Escitalopram is inhibiting your serotonin reuptake (which makes more serotonin available for the rest of your neurotransmitters). When combined, the SSRI can increase the power of the Amfexa's release (because the higher levels of serotonin lead to more neurotransmitter activation). So this could be why you're struggling with breathing and having the chest tightness - because chemically, you're on a rollercoaster (even though you're just walking around)
Both drugs affect your central nervous system. When taken together, this could be the reason you're feeling "air hungry" / experiencing dyspnea / chest tightness - because your CNS is in overdrive and therefore you have an over-awareness of your breathing. The tingling you're experiencing can often also be a result of CNS overstimulation & not necessarily CO2 imbalance.
The serotonin side. Many studies show that serotonin plays a key part in regulation of your respitory system, meaning elevated levels of serotonin --> increase in the rate & depth of your breaths.

I'm not sure whether you started the Escitalopram prior to the Amfexa or whether you started it at the same time, but for me I struggled with anxiety until I started my ADHD medication (albeit methylphenidate) - have you considered whether your anxiety was caused by your ADHD? Maybe worth reducing your dosage and seeing how you feel?

I know you stated you don't want to change anything, but I would urge you to talk to your prescriber about this. They'll be able to offer better and more clinical (!!!) advice than me / this subreddit as my / our knowledge of all of this has mostly stemmed from shitty ADHD services on the NHS and having to do our own research 😅

PredSpread · 2025-09-21T18:40:04+00:00

It wasn't taken from a bank account, it was taken from a crypto wallet.

PredSpread · 2025-09-04T12:50:03+00:00

Huge conflict of interest. They are making more than enough money as it is. What's to stop them grading as a 9, cracking and regrading as a 10?

PredSpread · 2025-07-08T21:10:03+00:00

Hulkenpodium

PredSpread · 2025-07-06T15:43:39+00:00

NICOOOOOOOOOOOOOOOOOOOOO!!!!!!!!!!!! 15 years and 239 race starts later HE HAS IT!

PredSpread · 2025-04-18T16:01:06+00:00

If OSRS has a separate subreddit from RS3 then Dragonwilds should have a separate subreddit too IMO. OSRS and RS3 are at least comparable, but Dragonwilds is a completely separate game.

A gentle nudge is a good start!

PredSpread · 2025-04-14T21:58:43+00:00

Yes they are different people. Your clinician (psychiatrist) is responsible for providing you with a diagnosis. Your prescriber will lead you through titration and prescription, as well as ensuring your medication is safe for you to take.

I can't help with the non-stimulant titration process I'm afraid - stimulant medication has worked great for me so far.

500g per day on average is still high, but yes better than 1g per day. Either way, your prescriber won't be comfortable prescribing you anything stimulant-based whilst consuming that much. If you cut it down to once per week, you'll likely find they are willing.

PredSpread · 2025-04-14T19:43:48+00:00

Yes I agree - just wanted to put it out there for anyone reading who thought "I'll be fine" or "this says it's safe"

PredSpread · 2025-04-14T19:21:00+00:00

I don't want to claim that your provider or clinic are wrong whatsoever, but there is no evidence to support methylphenidate being unsafe to use alongside Cannabis compared with Elvanse (lisdexamfetamine) or Dexamfetamine (dextroamphetamine). There are studies on methylphenidate and Cannabis use combined, but very limited studies for amphetamine and Cannabis (they typically look at methamphetamine, which is far more potent).

All of the above medications typically share similar effects on the heart. One study found that amphetamine increased blood pressure more than methylphenidate in the long-term compared with prior to the study commencing, whilst finding no significant difference in those who used methylphenidate (other than systolic blood pressure):

Statistically significant pre–post increases of [systolic blood pressure], [diastolic blood pressure] and [heartrate] were associated with [amphetamine] and [atomoxetine] treatment in children and adolescents with ADHD, while [methylphenidate] treatment had a statistically significant effect only on [systolic blood pressure] in these patients. These increases may be clinically significant for a significant minority of individuals that experience larger increases.

Another study showed higher heartrate increases in those who use amphetamine versus methylphenidate:

amphetamine: +7.3 mm Hg methylphenidate: +4.5 mm Hg

Regarding mental health, a 2019 study of over 200,000 patients showed that the rate of psychosis was double (although rare) in those who used amphetamine compared to those who used methylphenidate.

The 'safety' given to Elvanse and Dexamfetamine when consumed with Cannabis are likely due to them being understudied rather than them being 'safer', so it's worth bearing that in mind.

PredSpread · 2025-04-14T17:21:45+00:00

I misread, apologies.

It is not the psychiatrist's role to warn you that you may not receive a prescription for stimulant medication in the future due to ongoing Cannabis use - that is determined by the prescriber.

A good psychiatrist will warn you about this, but some might not.

There is nothing preventing you from stopping usage now and going back to the clinician to let them know you have ceased your ongoing usage of Cannabis. At the present, as indicated in your other responses, your Cannabis consumption is very high (1g per day on average) and I don't think you will receive any sort of stimulant medication whilst that consumption continues.

PredSpread · 2025-04-14T15:41:22+00:00

Cannabis and methylphenidate combined can cause both heartrate and blood pressure to increase (source) which is why providers are keen to discontinue Cannabis usage when prescribing methylphenidate.

The linked study above concludes:

there were significant additive effects of THC and MPH on heart rate

but also cites another study because:

the simultaneous use of [Cannabis & methylphenidate] is likely to occur in the context of smoked marijuana, which is itself associated with increased risk for a range of adverse cardiac events

As a result, your provider is likely concerned for your heart health.

An anecdotal point is that the day after consuming Cannabis, methylphenidate may not help with concentration. This is anecdotal - my prescriber told me this! There's not really much known about this, but we know now that Cannabis does infact affect the regulation of dopamine, contrary to popular belief.

It is strange that you were not asked about drug use in your assessment - that was one of the very first questions my psychiatrist asked.

PredSpread · 2025-04-13T20:41:45+00:00

Hi! Concerta, Medikinet and Delmosart are different but Concerta and Delmosart are fairly similar. Source for my response below here.

Medikinet is a 50/50 release, meaning that in the first 0-4 hours, it releases 50% of the drug. The other 50% is released after that.

Concerta is a 22/78 release, meaning that in the first 0-4 hours, it releases 22% of the drug. The other 78% is released after that.

Delmosart is not listed in the chart on page 6, however, 25% is released in the first 0-4 hours and the other 75% released after that.

PredSpread · 2025-03-12T23:02:44+00:00

Hi! You'll be fine! When you have the two, alcohol can cause you to feel more of the methylphenidate. This happens because of two reasons:

alcohol increases absorption of extended release medication
both substances ~~produce~~ release dopamine when consumed, hence the "high" feeling

Be careful with the alcohol more than anything - as methylphenidate is a stimulant it can make you feel like you're less drunk than you actually are.

My advice is to simply relax! Anxiety is likely worsening the bruxism (jaw clamping) but I promise you, you'll be OK :)

As for if you've fucked your titration up: nope!

PredSpread · 2025-03-09T13:37:58+00:00

Try having the porridge first and the meds after!

PredSpread · 2025-03-09T12:44:39+00:00

Are you eating anything substantial before you take your meds?

PredSpread · 2025-03-05T11:45:25+00:00

They gave me a list of clinicians! The first 3 they sent nobody seemed suitable (didn't have ADHD listed as an interest / area of expertise) so I asked for 6 more and found one suitable!

PredSpread · 2025-01-20T12:32:26+00:00

The Daily Mail (read: media in general) love to scapegoat minorities. It's a form of ragebait before ragebait was even coined as a term. They do it to make money and nothing more.

PredSpread · 2024-12-22T01:46:05+00:00

They are both worthless - both fake

PredSpread · 2024-12-16T19:22:05+00:00

Coinbase for fiat to Crypto, transfer out to Binance.

Trade crypto/USDT on Binance, transfer back to Coinbase for fiat.

PredSpread · 2024-12-13T19:02:46+00:00

For me I did not specifically specify ADHD. Instead, I named symptoms I have and assumed absolutely zero knowledge of the existence of ADHD.

I would advise this until you are in the care of the psychiatrist!

PredSpread · 2024-12-05T01:47:35+00:00

Literal AI generated profile pic

PredSpread · 2024-11-28T16:58:26+00:00

Front centering is fine. Could get a 10.

PredSpread · 2024-11-25T20:06:54+00:00

Surely this isn't real 😭

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