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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10565
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I was diagnosed with ADD a few years OKMH917100

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I was diagnosed with ADD a few years ago and was prescribed Vyvanse .25mg once a day. I now live in Australia and New Zealand throughout the year and Vyvanse is not available in either country. Vyvanse worked very well for me as I have difficult time stay focused on simple tasks and get overwhelmed easily if I have too much to do then I end up feeling stuck and get nothing done. As long as I took it before 11am I didn't have any problem sleeping at night while taking this medication. I'm a 48 year old female. A regular MD who specializes in ADD was my doctor in the USA but I think Australia and NZ may require me to see a mental health professional. Is there another prescription you can recommend that is available in these two countries?


Dr. Z :

Hello I believe I can help you with your concern

Dr. Z :

I am so sorry that Australia and New Zealand has limited medications to treat your ADD/ADHD

Dr. Z :

I spoke with a colleague recently about this and he told me that the only effective medications to treat ADD/ADHD in those two countries are Concerta, Ritalin, dexamphetamine, and Strattera.

Dr. Z :

Since Dextroamphetamine is the active metabolite in Vyvanse, I would suggest trying Dextroamphetamine, but I believe that it only comes in 5mg tablets, which is a low dosage and may not be effective for you.

Dr. Z :

Ritalin is a Methylphenidate type medication for the treatment of ADD/ADHD and works differently the Vyvanse and Adderall medications, but may be effective for you as well, but will have a different mechanism of action then the Vyvanse that you are used to

Dr. Z :

Concerta is also a Methylphenidate type medication but lasts longer than the Ritalin, by a few more hours, so that could be an option as well for you because of the Vyvanse that you are used to has a similar effective half-life.

Dr. Z :

And the Strattera is a non-stimulant type and selective norepinephrine reuptake inhibitor medication, which may or may not be effective for you. This medication is short acting, typically with a half-life of around 5 hours and may not be as effective as the Vyvanse, so I think medication is something you may not want, but I wanted to mention it to you

Dr. Z :

I see that you are offline right now, but when you get back online I would be very interested in continuing this discussion with you and talking about anything further you would like to share regarding your concern, so if you respond in the chat box I will be able to get back to you as soon as possible.

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Customer: replied 3 years ago.

I forget to mention that I have a slight case of glaucoma. Pressure is being controlled with Travian drops. I researched Dextroamphetamine and there seems to be a concern using this drug if a person has glaucoma. However, I read the reviews for Dextro and they seem very favorable and I would like to consider using it and would like your advise...thx!

Yes it is true that Dextroamphetamine can have an impact on patients who have glaucoma, but if you stay in a range of 5-15mg a day of the Dextroamphetamine then it should have no impact on your glaucoma, but you should tell your doctor about your glaucoma still and be advised accordingly by him/her. Also if you used the Vyvanse while being diagnosed with Glaucoma and had no adverse effects then the 5-15mg dose of Dextroamphetamine should not effect your glaucoma either. Best of luck and let me know if you have any other questions or concerns.
Customer: replied 3 years ago.

thank you very much! Appreciate your help =)

Anytime, I hope it all works out well for you :)
Customer: replied 3 years ago.

Hi Dr. Z


 


I was able to get a prescription for Dextro. As you said, it comes in 5mg tablets and my doctor is starting me out with 2 tablets a day and each week increase it by 1 tablet until I max out to 60mg per day (12 tablets). He is not familiar with the Vyvanse I use to take (50mg) since it is not available in Australia and wanted me to ask you your professional opinion of what he prescribed and how it compares. What has been the general feedback (good/bad) when your patients have taken either drug?


 


Thx,


 


Vanessa

Hi Vanessa,

The Dextro is not used as often in the United States because we have Vyvanse and Adderall. But the Vyvanse is called Lisdexamfetamine, which has the Dextro as a main component in it and why they are chemically similar. But studies show that the Vyvanse is usually more effective because of the added amino acid L-lysine and that the Vyvanse is absorbed in the gastrointestinal tract, while the Dextro is more fast acting and absorbed through the liver. So the Dextro will work faster, but may not last as long as your dosage of the Vyvanse. Also the Vyvanse usually has less side effects than the Dextro, but the side effects with the Dextro are typically not severe and are usually manageable. Also typically 10-20mg of the Dextro equals the strength of the Vyanse dosage you were taking at 50mg.

So overall I think this is the best medication for you, with positive results in studies and practice, to try although like I said the Dextro is not used often here in the U.S. as compared to the other stimulant medications, so I do not have any patients that have been prescribed this medication in the past or currently that I know of. But like I said it should have a positive effect for you based on what the studies say.

I want to wish you the best of luck and if you need anything else, please feel free to contact me at anytime.
Customer: replied 3 years ago.

Is the amino acid L-lysine something that can be prescribed to balance things out with Dextro?

No you can take the L-lysine over the counter, but it is bonded with the Dextro in a unique way that makes it effective and makes it a different chemical structure called Vyvanse, so taking the L-lysine with the Dextro will not combine to make Vyvanse, sorry. But L-lysine is an essential amino acid and I see no reason why you cannot take it anyway.
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Customer: replied 3 years ago.

Hi Dr Z~

 

I've been on 10mg of Dextro since last Saturday and noticed that as it wears off (3 hours later) I get a bit agitated then I feel like a bus crashed into me. If I take a 20-30 min nap I feel better but sometimes I'm not in a position to just lie down and take a snooze. I am supposed to go up in dosage 5 mg every Saturday. Should I spread this out so I feel more leveled out?

 

Also, over time will these symptoms fade away?

 

Thx,

 

Vanessa

Yeah that is the problem with the Dextro for some people, it wears off too soon. You can definitely try dividing the doses during the day to see if that has a longer effect for you and that you do not "crash." Typically the "crash" symptoms will not go away once the medication wears off, but if you keep on increasing the dosage to an effective level where it does not wear off so fast, then you will avoid that "crash" feeling.
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Customer: replied 3 years ago.

Hi Dr Z...thank you for answering all my questions. Regarding the crash symptoms, do they become more intense with higher dosages with some patients? Also, I plan on visiting family in the USA in March. Should I decide to get a Vyvanse prescription while I am there, is it typically advisable to switch from Dextro to Vyvanse over night or do I need to stop taking Dextro for awhile before taking Vyvanse again? Thx...

Hi, I saw your new question, but actually because you are a subscriber you actually only get to post a new question once a month on the mental health category (I know it is unfortunate, but I do not make the rules on the website, sorry). So I will answer it here for you, since most likely that new question you made will get closed I believe. The crashes can get worse at higher dosages with the Dextro that is true, but if you space the dosages during the day out more, the crashes will be lessened considerably. Also you can definitely switch to the Vyvanse from the Dextro without any major side effects, so when you do come back to the U.S. you can start taking the Vyvanse right away if you choose with no major problems.
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