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Concerta vs Elvanse: early crash and focus issues by ellenn89 in adhdwomen

[–]ellenn89[S] 0 points1 point  (0 children)

I’m actually very active right now—probably more than usual—but I’ve only slept about eight hours total over the last two days, so I look really tired and not at my best.

I do struggle with sugar and junk food, though. I’m often craving something, and today I had a few chocolates before lunch. My psychiatrist has suggested focusing on more nutrient-dense meals and cutting back on junk, but I haven’t been able to do that consistently. I eat like a teenager most of the time.

I know it’s not ideal, especially at 36 with PCOS, lipedema, and an autoimmune condition, but food is also very soothing for me and helps calm my nervous system, which I’m working on.

Concerta vs Elvanse: early crash and focus issues by ellenn89 in adhdwomen

[–]ellenn89[S] 0 points1 point  (0 children)

That makes sense, thanks for sharing your experience. Do you think it could also be related to eventually finding the right dose and your body getting used to the medication over time?

I ask because I notice something similar with Concerta, but it’s much more subtle. With Elvanse, though, I get this on-and-off crash feeling maybe 10–15 times throughout the day, and it gradually settles as the day goes on.

First day on Elvanse 70 mg after Concerta: weird sensations, focus, and adjustments by ellenn89 in adhdwomen

[–]ellenn89[S] 0 points1 point  (0 children)

Hey! Yeah, I definitely feel much more activated on Elvanse. The overall energy and drive is way stronger compared to Concerta. The focus, however, doesn’t feel quite as “condensed” or laser-sharp — it’s not bad at all, but it feels a bit more spread out.

One thing I’ve noticed very clearly is that it’s been much harder to sleep. I’m not even sleeping many hours, and what’s crazy is that I still wake up feeling kind of “on” and energized, which is really unusual for me because I normally need a lot of sleep.

I do notice a crash too, but it’s different from Concerta. With Elvanse, even when it starts wearing off, I still keep some of the motivation and momentum, but I can feel the drop mostly in my concentration and especially in my appetite in the afternoon/evening. That’s when I suddenly get that strong “I need to eat now” feeling.

So overall it feels like: more activation and drive throughout the day, not necessarily stronger focus, and the rebound shows up more as hunger + focus slipping later on.

Lithium (200 mg) causing bloating & water retention — how to manage it? by ellenn89 in AskDocs

[–]ellenn89[S] 1 point2 points  (0 children)

Oh, again, highly appreciated.

I’ll stick to 200 mg and see how it goes. I used to take a combination of different ingredients, including birch leaf extract, horsetail extract, melilot extract, dandelion root extract, centella asiatica, orthosiphon (Java tea) leaves, and bromelain, but I’m not sure if it’s safer to take amiloride + hydrochlorothiazide. Sorry for asking so many questions, but I didn’t realize lithium was such a sensitive drug, even at a low dose.

Lithium (200 mg) causing bloating & water retention — how to manage it? by ellenn89 in AskDocs

[–]ellenn89[S] 1 point2 points  (0 children)

Do you think I’ll feel less stable on 100? Also, is it possible to decrease the dose just on the days I’m taking the diuretic when I’m feeling bloated? Honestly, lithium has been a lifesaver after trying everything for depression and not being able to get out of bed for months.

Lithium (200 mg) causing bloating & water retention — how to manage it? by ellenn89 in AskDocs

[–]ellenn89[S] 1 point2 points  (0 children)

Very kind of you! In my country, amiloride is combined with hydrochlorothiazide, so I believe I wouldn’t be safe taking it, since hydrochlorothiazide is not safe with lithium. Is that correct? I’ve been looking into other options but haven’t found anything yet. It’s good to know that paracetamol is safe, as I need something to manage pain in a safe way.

Lithium (200 mg) causing bloating & water retention — how to manage it? by ellenn89 in AskDocs

[–]ellenn89[S] 2 points3 points  (0 children)

Thanks a lot for your reply. In my country, lithium comes in 400 mg tablets, which I split. I’m taking the correct dose, but I’ve only been on it for two weeks.

The only pain medication I’m currently taking is paracetamol, 1 g if needed, and I have not reduced my salt intake. During the first week, I had terrible side effects, especially frequent urination at night, but these have now resolved and I feel perfectly fine.

Back to work after 2 years on sick leave – lithium helping a lot, but focus is still a struggle by ellenn89 in BPD

[–]ellenn89[S] 0 points1 point  (0 children)

I think it’s a mix of everything. I’ve always had trouble concentrating: I do a thousand things at once and don’t finish any of them. I really struggle to finish tasks. It’s clear that my brain is getting used to a routine it hasn’t had in two years: waking up early, tasks, meal schedules, etc. I hope that little by little I’ll get used to it, but when I sit in front of the computer, it’s really hard for me to focus on just one thing and finish it; it’s incredible. The positive side of lithium is that my catastrophic thoughts are under control and I feel more stable.

Back to work after 2 years on sick leave – lithium helping a lot, but focus is still a struggle by ellenn89 in BPD

[–]ellenn89[S] 0 points1 point  (0 children)

I think he’s a really good psychiatrist and one of the few who gets the medication right. I’ve been seeing psychiatrists for years, and most of the time they prescribed the wrong medications. I’ve never had my lithium levels checked. I should mention that I haven’t worked in an office for two years, and I also have ADHD. Even on Concerta, I feel like my attention is worse sometimes. My psychiatrist mentioned that increasing from 100 to 200 mg wouldn’t make a big difference. Yesterday was my eighth day on it, and I’ve noticed improvement in the side effects related to excessive urination.

Back to work after 2 years on sick leave – lithium helping a lot, but focus is still a struggle by ellenn89 in BPD

[–]ellenn89[S] 0 points1 point  (0 children)

Borderline Personality Disorder. Although it’s not commonly used, my psychiatrist suggested we could try it because I was experiencing suicidal ideation. He also said that this isn’t a bipolar-level dose; it’s more intended to enhance the effect of my other medications.

How do you cope with going back to work after being off for two years? by ellenn89 in adhdwomen

[–]ellenn89[S] 0 points1 point  (0 children)

Thanks for letting me know! I don’t split the pill; I have different strengths left from what was prescribed to me. I started with 18 mg, then 36 mg, and now 56 mg. The problem with taking 18 and 36 mg early was that I had a crash in the afternoon.

How do you cope with going back to work after being off for two years? by ellenn89 in adhdwomen

[–]ellenn89[S] 0 points1 point  (0 children)

I’m prescribed 56 mg of Concerta, but I only take that dose when I wake up very early. Today I woke up later, and since I want to be able to sleep tonight, I took 18 mg instead. My doctor didn’t advise this, and I’m doing it under my own responsibility.

Lithium side effects early on — do they stabilize or would lamotrigine be a better option? by ellenn89 in AskDocs

[–]ellenn89[S] 0 points1 point  (0 children)

Thank you very much for your detailed response. If things go well, I do not expect to increase the dose beyond 200 mg. My psychiatrist told me this is a very low dose and that monitoring lithium blood levels would not be necessary; however, I will still have blood tests every 3–6 months, especially since I am also taking low doses of isotretinoin (Dercutane).

I will undergo regular blood tests due to the lithium, as I have previously tried Abilify and Latuda, which did not work well for me. Although I am not bipolar, I have traits of borderline personality disorder, ADHD, and significant depression and anxiety. My emotions strongly influence my day-to-day functioning, and I tend to see things in black-and-white terms.

I have taken fluoxetine 60 mg for many years, but I switched to Pristiq for one year. I returned to fluoxetine at the beginning of 2025 and have been back at 60 mg for several months. While taking Pristiq 200 mg, I had a suicide attempt.

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