Switching medication for the third time, unsure where to go from here
Hi all, I’m 6 weeks into titration. I initially started with Meflynate XL (Methylphenidate), but due to unpleasant side effects, my prescriber suggested switching to Elvanse.
I’ve been on 20mg for 2 weeks now and am having mixed feelings towards it. On the positive side, it’s been helping with productivity and focus (though quite inconsistently). However, it’s been also causing some weird emotional and social changes. For one, I’ve become much more serious and rigid socially and often have to force myself to laugh sometimes even with people I’m close with. I’m also more irritable and snappy. I also get moody and depressed as it wears off until late in the evening when I return to my usual self.
While the improved focus is helpful, I’ve also been hyperfocusing excessively. For example, I spend an incredible much time drafting emails due to overanalyzing details, and I also hyper-fixate on symptoms, leading to spend hours of unproductive Googling.
Though 20mg is considered very low dose, I think it’s too much for me. For the past few days, I’ve been taking a reduced dose (10mg) by dissolving the capsule in water. This has lessened the side effects, but I’m unsure if it’s the right long-term solution.
My prescriber read my report and has offered three solutions:
- Stay on Elvanse 20mg for a little longer to see if side effects fade in time
- Switch to Dexamphetamine
- Try to a non stimulant (Strattera)
I’m feeling a bit stuck on what to do next. I’m tempted to ask about adding Guanfacine to Elvanse to help with emotional dysregulation and numbness, but I’m not sure if she’ll agree. I’m also unfamiliar with Dexamphetamine and unsure if Strattera is worth exploring.
Has anyone been in a similar situation or have insights on these options?
Thanks so much x