WLS & ADHD meds

[Christina J. 17]

I’ve recently been diagnosed with ADHD as an adult and have started taking Adderall XR. My doctor was concerned with my absorption that it may not work so well and I am inclined to agree. It makes me very tired all day and I’ve lost all motivation to do ANYTHING. The first week of it I was hyper focused and accomplished so much but then as I got used to it it quit working. Also I have a hell of an energy dip between 2:30-5:00pm consistently despite all the right Vitamins, Water and Protein.

Has anyone else dealt with this? Or tried a different medication with success?

[lizonaplane 1,612]

If you had bypass, you may need to take a non-extended release version. You would need to take it a few times a day rather than once a day. Talk to the doctor prescribing yet, or have them talk to your surgery team. Good luck!

[Arabesque 7,197]

Some meds are absorbed in different areas of your digestive system & as @lizonaplane suggested, a conversation with your prescribing doctor is needed to discuss where your meds are being absorbed & then may be seeking alternatives.

Energy dips aren’t uncommon while losing. I found electrolyte drinks helpful. I drank hydralyte - found it a bit sweet though so I’d add twice the Water to dilute it.

[catwoman7 11,210]

yes - extended release versions of meds tend to not work too well for us - but if there's a non-extended release version of Adderall, that might do the trick...

[lizonaplane 1,612]

1 hour ago, catwoman7 said:

yes - extended release versions of meds tend to not work too well for us - but if there's a non-extended release version of Adderall, that might do the trick...

I'm almost positive there is an non-extended release version of Adderall. It would just be Adderall, rather than Adderall XR. It would be the original form that would have to be taken multiple times a day rather than the "new and improved" once a day XR version.

[Christina J. 17]

My doctor switched me to 5mg of D-Amphetamine/ Salt twice a day and it eliminated the energy dip completely. I’ve also tried to make sure that I am not missing my high Protein Snacks. So far so good.

[dal101 62]

If I may ask, what made you notice you had ADHD as a adult ? I suspect I have the same thing.

[ShoppGirl 4,749]

There is definitely an immediate release version. I was on it for a couple years because it was cheaper than the newer extended release version. It’s not uncommon to feel dips of energy later in the day when taking Adderal Xr either. Some doctors will prescribe the XR in the am and a small dose of the immediate release in the afternoon to help with this. That’s for non WLS patients though. The solution for you will most likely be as others suggested to take the immediate release a couple times a day.

[Christina J. 17]

On 7/17/2021 at 11:12 AM, dal101 said:

If I may ask, what made you notice you had ADHD as a adult ? I suspect I have the same thing.

It started with discussing my sleep medication with my counselor. I had expressed that it was difficult to fall asleep because of how busy my mind is. This led to some more questioning and then research on my part because ADHD in females is often much harder to notice because we learn masking at an earlier age than males do. Then I was officially tested through a psychiatrists office. Now I know that things like my rejection sensitive dysphoria, inability to stick to routines, and many other issues were all related to this.

[solman 1]

I'm in this boat. The literature is clear that patients with the same surgery can experience very different ADHD drug absorption (from other patients and from themselves pre-surgery) after surgery. It is almost certainly necessary for you and your psychiatrist to carefully observe the effects of the drugs and adjust as needed (especially since your own absorption may change in the aftermath of your surgery).

I was taking Adderall XR before surgery. We've decided to put me on Vyvanse, which I'm in the process of gradually ramping up now. Because Vyvanse becomes active after it is in the blood, strange and unexpected changes in absorption should be more tolerable. But we are concerned that it could be absorbed and become active so late that it is ineffective in the morning and/or interferes with my sleep. It is way too early for me to answer these questions.

Another thing we considered is dermal Methylphenidate. This would avoid my gastrointestinal system altogether. We may yet wind up there. Apparently there are dermal Adderall studies going on, so this may be an option in future years.