I was diagnosed with a ADHD around the age of 10 and am now 28. Since I was a kid I've been on everything, mostly adderall for the past few years [20 mg, 3X], but I just moved and my new doctor didn't want to continue my adderall prescription so he put me on Vyvanse. I don't notice a thing, its been a week, and even the first day I didn't feel like I was able to focus or able to finish any of my designs [I study Architecture]. I am on 40 mg and even though I know this is a low dose, I should at least have noticed something, especially the first day. very weird and very disappointed since I was told it was a "wonder drug" for some people. I really hoped it would be for me as well, but not the case. Really bad timing since I am now struggling to get my portfolio together, but I can't seem to stay focused for more than 10 minutes. Is this normal? I don't know the equivalency ratios between these medications because the information Ive found is so inaccurate. Do I just need a higher dose?
I've noticed that Dr's around here are prescribing the Vyvanse more and more along with trying to switch people from adderall to it. With that the ones that have had ADHD for several years they started giving a small adderall IR dose usually 10mg with 60 mg of Vyvanse, none of them seem to care enough to find out why, but I would theorize that the adderall helps with the inattentiveness more and is taken in the AM to overcome the people accustomed to adderall for several years and the initial kick/waves and by the time it would normally wear off they don't really notice since the Vyvanse is going in their system so there isn't the adderall crash many complain about. Maybe your Dr. is willing to try that with you?
Also it could be because a lot of the Ins companies over the past few years have put dispensing limits to 60 count on the medication regardless of dose which I was on 15mg 3's and see you were on 20mg which there is no way to get around the insurance limitations in your case since the XR's have a limit of 30 fortunately my Dr at the time just moved it to 30mg 1/2 TIB as he wanted to move me to XR's 2x's daily but there wasn't a way for the mg's to add up and stay under 30 count.
Later I was basically forced to go to the XR's and have noticed a stigma for us old timers who were given the IR's before the XR's existed or were to costly and that last year of IR's it seemed like I would get dirty looks and more n more questions even though I never asked for an increase nor had 1 the entire time I was on it and like you I work in a professional roles which they were all aware of and I typically was always in a suit or similar having to rush there to get the written rx.
It also happened to start around the same time the reports of college abusers were in major publications and news stations and of the people I know with ADHD most were already switched to XR's I was able to avoid it since the doc was compassionate enough with Ins premiums for business owners and the high costs of the XR's wo Ins and didn't force it since he was paying nearly $1000 a month for ins and understood why I dropped mine and waited till I was on a new plan (or realized I was when I used it for my annual checkup)
The handful of people that were on adderall before and take Vyvanse now are on a 60mg dose w/ 10mg of adderall IR, I don't know what their prior dose was, but I imagine rather high or similar to yours.
I did try the Vyvanse for a cpl week as the XR's really don't seem to work the same for me well (even though I would take 1 ir in the AM then split the other 2 into 4+ doses throughout the day to minimize the sweating/anxiety) but I did notice that the inattentive aspects for me at least were a lot worse with the Vyvanse and getting started was extremely difficult, but when/if I could get moving into the task right away it did seem to work well at keeping focused and last a full 10-12hr workday + 1hr morning commute where the XR's barely make it till lunch then a dreaded blank stare n fog is there the rest of the day and basically a useless mental state for anything requiring real thought which unfortunately was usually the only time I had to work on long term projects, ultimately after much hassle and letting them try different things I was able to get 1 IR and XR daily but wish they would agree to letting me try the Vyvanse and 1ir like others are on as I think that would work for the longer then typical hours needed and leave the IR to utilize for the inattentiveness since even with the XR/ir it doesn't cut it with a typical 14hr day (with commute) and nothing gets done by the time I get home.
But the inattentive factor is my biggest struggle which has only worsened over the years as technology as fast as it moves is really still the same at its core as it was in the late 90's
Either Way 40 mg if you were on 20mg ir TIB seems extremely low and I would think a minimum of 60 mg is needed and believe they come in even higher doses. Let alone even if mg for mg they were the same the Vyvanse is rated for a longer time release, so you would be receiving less mg per hour which I'm sure your body has become accustomed too.
Have you tried taking a break for at least 2 weeks from the medicine entirely? If your Dr. won't work with you and you don't seem to notice any benefits from the med you really have nothing to lose trying that and seeing if you really aren't benefiting at all from the treatment and can rule out if it may just be a tolerance/effect from IR to XR adjustment as well?
