CW: References to suicide.
I will try and keep this succinct.
I was diagnosed with ADHD-C in November 2022 and started on 20mg Elvanse/Vyvanse/Lisdexamfetamine. By Spring 2023 I'd worked my way up to 40mg. Two weeks ago, February 2024, I started on 50mg.
The 50mg has been a massive help to me. I've been much more productive and felt much more fulfilled. I stopped feeling suicidal. Around a week after upping the dose, I began noticing my heart racing and occasionally feeling tense or hyper-aware of parts of my body. The racing heart in particular is kind of irritating and I'd rather it stop. I've checked my blood pressure and it's healthy.
I recall similar sensations for maybe around a month after I was first put on Lisdexamfetamine but I am not sure how long they lasted for. I don't recall these sensations when I went from 30mg to 40mg.
I'm looking for some assurance that if I maintain a healthy lifestyle and check my BP regularly, that this will resolve itself in-time?
Relevant medical info:
- Cisgender man
- Late 20s
- approx. 90kg/198lb
- approx. 22% bf
EDIT: Updated with this morning's BP reading.
119/79 80bpm
EDIT 2: I'm going to provide reasoning as to why I haven't gone straight to my doctor about this. Firstly, the dose increase has been life-changing and I'd be so upset if I had to go back down. Secondly, I live in the post-satirical apocalypsescape formerly known as the United Kingdom and am therefore under the care of a private psychiatrist. Just to get on the phone with them would cost £100s and I'm relying on family assistance, which I feel guilty enough about spending. I could, within a few weeks, arrange to see my general practitioner for free but I don't think they'd be able to suggest anything aside from reducing my meds. Thirdly, I have faint memories discussing palpitations with my psychiatrist last year and he said that as long as I was monitoring my BP they'd pass.
EDIT 3: I honestly appreciate the concern of all of those who have taken the time to post. I've decided to send a message to my psychiatrist explaining the situation.
EDIT 2024-03-21: Received an email from my psychiatrist stating that as long as they're manageable and the dosage is helping, I'm safe to continue. They encouraged me to keep monitoring my blood pressure and heart rate. They suggested I be vigilant of chest pains or shortness of breath.
I can't say for lisdexamphetamine itself, but with plain old methylphenidate (ritalin) I found everything was really quite quick to adapt. I take Concerta 18+27mg in the morning and Ritalin 20mg on afternoons when I need it, so a total of 65mg in a day. When I started I had no real side effects but I did have a whole bunch of trauma based issues because here, finally, was the cause of many of my problems and my parents had lied to me about my diagnosis for 13 years. That said, my psychiatrist was gradually increasing my dose and when we tried the 54mg Concerta and the 25mg Ritalin I knew on dose 1 of each I was over my limit. Sweating, rushing, agitation, and generally feeling awful, it was too high a dose.
That all said, completely unrelated to my meds I had a heart infection last year. A bacteria (streptoccocus sanguinis for the curious) ate a valve and my first symptom was a chest infection. I had fever for a couple of weeks, some gout symptoms, coughing, sweating, and eventually I had to drive to the emergency room. It took me 3 rest stops to walk the 100m from my car to the emergency room and I knew I was in trouble. They thought it may be Covid but no, I had bilateral pneumonia and when the doctor listened they thought I must have a bicuspid valve. It turned out most of the valve was eaten away and the little bits of valve left were flapping away, sounding like a bicuspid valve. Further scans figured out the issue and I had an emergency flight from my country town to a larger city to get an emergency valve replacement. Two days after surgery I was up and walking again with a lovely new scar and a prescription for warfarin and a beta blocker. So if you are feeling weirdness with your heart it is probably a good idea to get it checked if you can manage it. I am in Australia so none of that cost me a single dollar, but where you are it may be different.
Thanks for the detailed response. I'm sorry to hear you had to go through something so traumatic.
Nah, it was honestly a really cool experience. It was scary at times, yeah, but I absolutely love medical sciences and it was a fascinating experience. I had world class healthcare with experts and overall fantastic facilities and now I have made a really good recovery. Most people with two collapsed lungs and a sternotomy (I think that is the correct term for open heart surgery) have long term damage, but I work an intense physical job and feel better than I did for at least a few months, maybe a couple of years, before it all happened. Now I have to take some extra meds on an ongoing basis but as a bonus I sound like a cartoon bomb about to go off. Also my partner can hear my heart ticking from the other room, so that's pretty cool.
No joke, I find your positive outlook incredibly admirable :)
Long may your good health continue.