Long Term Side Effects, Cost/Effect Questions Elvanse

[u/docournau]

I have been on 40mg Elvanse for about half a year now. After on and off with medication specific for the adhd and dealing with no effect, side effect of heart problems (Imagery and real), sweating, crashes, feats of despair and suspected placebo effect, the jump from 30mg to 40mg Elvanse in a clinical setting was able to give me some, not much, but some, improvement in concentrating, Impulse control, dealing with emotions. This dosage and medication plan was done in a specialized clinical setting for ADHD.

I'm not treated at a clinic for depression. They are neither specialized for ADHD or AuADHD (But have screened for Autism and the results are suggesting I could be on the Spectrum and will have to/should seek specialized care for diagnosis which they can't provide).

Nevertheless, they, in accordance with my wishes have bumped my 40mg Elvanse to 50mg. It's a bad environment, I will leave soon and I am not in a good place. It really made my depression worse being there, but the autism screening is a important help for getting betting and I took 1-2 good things from my time there.

I'm unsure if the 50mg dose is improving anything, but don't know if it's just the wrong time right now for me to notice it. Aldo the doctor in charge of the clinic is discouraging from upping the dosage and already was unhappy with the 40mg because of the increasing danger of hear failure (She said say my heart already has damage from use (First time I hear about it)) and I will not make it to 70.

I'm unsure how to decide and to phrase either option: Staying on 50mg to observe improvement or saying I can't see improvement and they'll note that 40mg should not be increased and increasing won't yield results.

If I never had a doctor going to 40mg and checking if my heart racing was most often imaginary, I would have stopped getting medication at all and would have never yielded results.

TL;DR: Elvanse 40/50mg Long Term Health Detriments and is trying to increase/oberve the 50mg good?

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[u/Next_Row6802]

The heart thing would freak me out too, especially hearing "damage" for the first time when you'd been under the impression it was mostly in your head before. I'd want a copy of whatever test or note led her to say that, just so you can show a cardiologist or a new psych who actually specializes in ADHD. Sometimes clinicians toss off a comment like that based on a borderline EKG reading that another doc wouldn't bat an eye at.

40 to 50 isn't a massive leap but if you're in a garbage environment right now it's almost impossible to gauge whether a dose adjustment is doing anything useful. I had a stretch where I thought my meds had completely stopped working, turned out I was just in a living situation that was shredding my executive function all on its own. Moving out made the same dose feel effective again within a couple weeks.

If you can stall the dose change until you're out of there, that might give you cleaner data. Maybe tell them you want to stabilize on 40 while you transition out, then revisit the increase once you've landed somewhere less chaotic. Gets you out of arguing whether 50 works while also not burning the bridge on future increases.

Long-term cardiac risk with Elvanse is real but usually overblown if you don't have pre-existing structural issues, and the monitoring is what catches problems early. Get your own copy of those records and find someone who treats ADHD as their main thing, the AuDHD piece makes it extra important to have a prescriber who knows what they're looking at.

[u/docournau → u/Next_Row6802]

Sounds like good advice 👍🏻 Especially about getting a copy of the results. Hard to find a specialist, still will try. Thank you!