Vyvanse/Elvanse (Lisdexamfetamine) and Abilify together? ADHD and Bipolar

[HLon99]

Dear Forum,

For the last 8 months I have begun the painstaking process of getting my drug regiment right. I have ADHD and Bipolar Disorder. I was first put on Lamictal (Lamotrgine) 200mg for bipolar depression which worked great, however, didn't help with hypomania. I was then put on Abilify (Aripiprazole) 5mg which helped totally even out my moods. However, I continued to struggle with my ADHD symptoms.

I was then put on Strattera (Atomoxetine) 40mg trial for about 6 weeks, and I showed no signs of improvement. So now, my doctor has decided to give me a trial of Lisdextamfetamine otherwise know as Vyvanse in the US or Elvanse here in the UK. I don't know what to expect from this combo, because I earlier tried using my old ADHD med (ritalin) with an antipsychotic and they completely counteracted each other. Does anyone have any experience with these two drugs, or any advice on dealing with comorbid ADHD and Bipolar.

Would be greatly appreciated.

Thank you in advance,
-H

P.S. If this combo doesn't work out is it worth asking my doctor to switch the Abilify for Lithium or Valproate so my mood stabiliser won't counteract my stimulant?

 

[Tawny]

It sounds like you need to speak to a consultant pharmacist.

 

[HLon99]

It sounds like you need to speak to a consultant pharmacist.

Thanks for actually taking the time to reply tawny. I spoke to my psychiatrist about possible interactions, and while he says its possible that the antipsychotic will dull the effect of the stimulant, in low doses in theory it shouldn't be a problem. However, going by personal experience and what I have read on reddit, I found that the antipsychotic completely blocks the stimulant. I guess I'll just have to wait and see.

If it doesn't work out i'll ask my psychiatrist to switch out the Aripiprazole for Depakote or something. Do you have any experience with Depakote (sodium valproate). If so are there any side effects I should be aware of?

 

[keith74]

If it doesn't work out i'll ask my psychiatrist to switch out the Aripiprazole for Depakote or something. Do you have any experience with Depakote (sodium valproate). If so are there any side effects I should be aware of?

Depakote (known as Epival here in Canada) was my wife's main medication for most of her adult life. When she became manic, she decided she no longer wanted to be be on it but just recently both myself and her psychiatrist was able to convince her to go back on it now that her mania has mostly subsided. It was pretty effective for her and with apparently no noticable side effects (she has historically taken around 500-1000mg). We are aware of the toxicity to the liver hence she gets regular blood tests. We don't have (or plan on having) children so the issue about birth defects is not an issue for us. She has always been (and still is) concerned about the long term toxicity of it to her liver and down the road is considering looking for an alternate. But so far it is the one med she has the most history with and it apparently has served her well so far.

 

[keith74]

Depakote (known as Epival here in Canada) was my wife's main medication for most of her adult life. When she became manic, she decided she no longer wanted to be be on it but just recently both myself and her psychiatrist was able to convince her to go back on it now that her mania has mostly subsided. It was pretty effective for her and with apparently no noticable side effects (she has historically taken around 500-1000mg). We are aware of the toxicity to the liver hence she gets regular blood tests. We don't have (or plan on having) children so the issue about birth defects is not an issue for us. She has always been (and still is) concerned about the long term toxicity of it to her liver and down the road is considering looking for an alternate. But so far it is the one med she has the most history with and it apparently has served her well so far.

I forgot to mention that she suspects one side effect of Epival on her is that it makes her hair curvy/wavy. Her hair was straight when she was growing up and her entire family and extended family all has straight hair.

 

[Ruma55]

Dear Forum,

For the last 8 months I have begun the painstaking process of getting my drug regiment right. I have ADHD and Bipolar Disorder. I was first put on Lamictal (Lamotrgine) 200mg for bipolar depression which worked great, however, didn't help with hypomania. I was then put on Abilify (Aripiprazole) 5mg which helped totally even out my moods. However, I continued to struggle with my ADHD symptoms.

I was then put on Strattera (Atomoxetine) 40mg trial for about 6 weeks, and I showed no signs of improvement. So now, my doctor has decided to give me a trial of Lisdextamfetamine otherwise know as Vyvanse in the US or Elvanse here in the UK. I don't know what to expect from this combo, because I earlier tried using my old ADHD med (ritalin) with an antipsychotic and they completely counteracted each other. Does anyone have any experience with these two drugs, or any advice on dealing with comorbid ADHD and Bipolar.

Would be greatly appreciated.

Thank you in advance,
-H

P.S. If this combo doesn't work out is it worth asking my doctor to switch the Abilify for Lithium or Valproate so my mood stabiliser won't counteract my stimulant?

I also take Lamictal and Abilify and have taken Vyvanse in the past and found it worked well. I take adderall now and that works slightly better for me.

 

[HLon99]

I also take Lamictal and Abilify and have taken Vyvanse in the past and found it worked well. I take adderall now and that works slightly better for me.

Thank you for your reply. Its rare to find another person with both ADHD and Bipolar (lucky us right) on forum. Did you find that the abilify somewhat dulled the effect of the vyvanse or the adderall? Also have you ever tried Quetiapine (Seroquel). I'm thinking of switching to it because unlike abilify its very short acting which means I can take my Vyvanse in the morning and my antipsychotic at night without one interfering with another.

 

[Ruma55]

Thank you for your reply. Its rare to find another person with both ADHD and Bipolar (lucky us right) on forum. Did you find that the abilify somewhat dulled the effect of the vyvanse or the adderall? Also have you ever tried Quetiapine (Seroquel). I'm thinking of switching to it because unlike abilify its very short acting which means I can take my Vyvanse in the morning and my antipsychotic at night without one interfering with another.

I know lucky us! I never noticed any dulling of the vyvanse when taking the Abilify, I took the Abilify at night and the vyvanse in the morning so I don’t know if that made a difference. I recently stopped taking the Abilify because I can’t afford to pick it up from the pharmacy and I haven’t noticed that my ADHD meds are working any better. I’ve had a couple of doctors put me on seroquel and I couldn’t handle the drowsiness, I would literally sleep until 2pm and still wouldn’t be able to keep my eyes open all day- people say that side effect wears off eventually but I could never get through it.

 

[HLon99]

I know lucky us! I never noticed any dulling of the vyvanse when taking the Abilify, I took the Abilify at night and the vyvanse in the morning so I don’t know if that made a difference. I recently stopped taking the Abilify because I can’t afford to pick it up from the pharmacy and I haven’t noticed that my ADHD meds are working any better. I’ve had a couple of doctors put me on seroquel and I couldn’t handle the drowsiness, I would literally sleep until 2pm and still wouldn’t be able to keep my eyes open all day- people say that side effect wears off eventually but I could never get through it.

Thanks for that. Its good that it works well for you, I've read a lot of comments on reddit saying that abilify blocks vyvanse for them and its something that I have definitely experienced myself. I don't think that taking it in the evening will make any difference because Abilify is very very long acting (half-life 72-94hrs), part of the reason why I want to switch to seroquel (half life 8-12 hrs), so that I can take it in the evening and it wears off in the morning and I can safely take my vyvanse (kind of yin-yan effect). Which dose of Abilify and Vyvanse were you on? What are you taking now to stabilise your moods for bipolar?

 

[Ruma55]

Thanks for that. Its good that it works well for you, I've read a lot of comments on reddit saying that abilify blocks vyvanse for them and its something that I have definitely experienced myself. I don't think that taking it in the evening will make any difference because Abilify is very very long acting (half-life 72-94hrs), part of the reason why I want to switch to seroquel (half life 8-12 hrs), so that I can take it in the evening and it wears off in the morning and I can safely take my vyvanse (kind of yin-yan effect). Which dose of Abilify and Vyvanse were you on? What are you taking now to stabilise your moods for bipolar?

I’ve been on all different doses of Abilify from 2mg to 30mg and the vyvanse worked fine. Right now I take 15mg of Abilify, 200mg of lamictal, and an anti-depressant. I also take restoril to sleep and 80mg of adderall a day. I’ve been on this combo for years and it works well and keeps me stable. It’s hard when you’re trying to figure out what meds you need, switching and switching and all the side effects sucks. Once you figure out what works for you it gets better.

 

[HLon99]

I’ve been on all different doses of Abilify from 2mg to 30mg and the vyvanse worked fine. Right now I take 15mg of Abilify, 200mg of lamictal, and an anti-depressant. I also take restoril to sleep and 80mg of adderall a day. I’ve been on this combo for years and it works well and keeps me stable. It’s hard when you’re trying to figure out what meds you need, switching and switching and all the side effects sucks. Once you figure out what works for you it gets better.

Thanks for that. I feel like I'm coming close to finding the right combo for me.

 

[Bpdadhd]

A little late to the party but trying to find some info on elvanse (vyvanse) and abilify, came across your post so I'm just wondering if you have an update and if you're still taking them, if you are how are you finding it? Best time to take the abilify? I'm on 30mg elvanse, I don't have bipolar but I have bpd so I'll be starting 5mg abilify tomorrow to help with my bpd symptoms as they're unbareable atm, big ol waiting list for therapy, you know the drill!

 

[HLon99]

A little late to the party but trying to find some info on elvanse (vyvanse) and abilify, came across your post so I'm just wondering if you have an update and if you're still taking them, if you are how are you finding it? Best time to take the abilify? I'm on 30mg elvanse, I don't have bipolar but I have bpd so I'll be starting 5mg abilify tomorrow to help with my bpd symptoms as they're unbareable atm, big ol waiting list for therapy, you know the drill!

Yes, I'm still on that combo. I take 2.5mg of Abilify and 50mg of Elvanse. I started off with 30mg as well, but the dose was too low for my ADHD.

When ADHD is comorbid with a mood disorder, such as Bipolar or BPD, its vital to get the mood stabilised first before anything else. My psychiatrist, who is a specialist in this field told me that he is currently conducting a study on patients with comorbid bipolar and ADHD. It has shown that when Bipolar and ADHD patients take solely Elvanse, it has a five fold potential of inducing a mood episode. However, when Elvanse is taken with a mood stabiliser such as Abilify, this risk diminishes to a negligable level.

I would imagine that the same would apply to comorbid BPD and ADHD patients. I really don't know why your psychiatrist didn't work on stabilsing your mood first before treating the ADHD as is recommended, but que serra serra. Important thing is now that you stick to this regiment.
And yes it does actually work! BTW take the abilify at night and the Elvanse in the morning, you'll thank me later.

Another thing is try getting therapy as a matter of urgeancy. Go private if you can. Whilst mood stabilisers work fantastically for Bipolar, the same is not often said about BPD. Whilst they can stabilise mood in BPD, they do nothing to address the core psychological symptoms such as black and white thinking, splitting, relationship problems etc. The only thing proven to be effective for that is DBT. What are the symptoms that you are most concerned with?

 

[Bpdadhd]

Ah this is so Informative, thank you so much! Honestly, I've been back & forth a while saying that I'm almost convinced elvanse was triggering my moods / bringing on more episodes but was also definitely helping my adhd, so I was v conflicted on what to do! Raised this a few times with my psych but it kind of got pushed off as me just going through a "difficult" time & told me to look up some websites he gave me & put me on waiting lists for basic group therapy (that I've already had and they weren't affective for me may I add) I've asked for DBT LOADS, have been refused everytime as it's "too expensive" & unfortunately I'm classed as highfunctioning. When in reality I'm just really resilient & v good at masking, almost get punished for being so self aware & actually wanting to work on yourself, make it make sense. They obviously know how serious my eps are & have been in the best but still seem to over look it?? I'm definitely going to look into a private practitioner for DBT, I'm just unfortunately a student who's currently on furlough from a part time job so it's weighing up the costs too! I'm glad there's some good news about this combo though, I've been abit nervous tbh as my experiences with ssris are awful so wasn't sure how I would react to an antipyschotic! I'm actually picking it up this afternoon, was going to wait until the morning to take it but I'll take it tonight so thank you for that bit of info too!!

 

[Bpdadhd]

Also the symptons that are worrying me the most is that even though it's not common, is the increased heart rate. I had severe panic attacks for two weeks from my side affects on elvanse, obviously they finally settled but I don't think I can deal with that again!