u/Laurenamandaa

Advice please 😊

As the title says, I'm nearing the end of my titration. I was given the green light at the beginning of titration to experiment with Elvanse dosage as I had some issues when moving up too fast. (I think because I work in a pharmacy she trusted me to do it? Lol)

I've been on 40mg elvanse at 7am and 20mg at 11am for a month, and as far as I could tell it's been great. The split dose really helps me get over the crash I was getting at 3pm and my energy levels have been really consistent all day.

It's been playing on my mind whether or not this is the right dose though. I've still been a little scatterbrained but nowhere near pre meds, which, realistically could just be my personality.

I decided to try the next and final dose. 50mg 7am and 20mg 11am. Basically just to see if I'm settling at the right dosage, if it's too high I'll happily go back down.

Currently on day 3 of the new dose and last night I slept for 10 hours!? I'm wondering if anyone has this experience when increasing, just feeling really tired at night? I honestly cannot remember from previous times 😂 I'm thinking maybe it's just my body getting used to the higher dosage but at what point would I know if it's too high?

My BP and HR are absolutely fine my resting HR overnight was 60bpm (I've found my RHR to be quite low even on Elvanse)

No other side effects, I've had a dry tongue, not full dry mouth and I make sure to drink plenty but that's been my only elvanse side effect.

So basically after that ramble, I'm interested in people's thoughts on it?

I've posted here before regarding my titration and it's been a shambles.

Started medikinet XL. Took 5 days and filled out a form with my side effects (headache nausea, some palpitations). Changed to Elvanse (which was what was written in my initial assessment plan)

The titration was to go:

Week 1 30mg

Week 2 50mg

Week 3 70mg

I about had a panic attack at the speed of it. I work in a pharmacy, so I know SOME about medication.

I spoke to my prescriber who agreed I could take 40mg week 2

So what I actually did and where I am:

Week 1 30mg (felt fine)

Week 2 day 1 50mg (thought I'd give it a try as it was written in the plan - got intense congestion and my prescriber called me and we discussed staying in 40mg for a week)

Week 2 40mg

Week 3 50mg for 2 days. Spoke to prescriber again as I'd been really drowsy but this was mid heatwave and pre menstrual cycle.

Back down to 40mg.

I am currently on day 6 of 40mg and I intend to stay on it for at least 2 weeks.

So the last 2 days I've been really irritable or low mood.

I'm wondering if it's the Elvanse itself OR the fact that my initial dosage was all over the place and my body is just like wtf are you doing.

I realise literally nobody else will have taken it like I did but has it made anyone irritable at first and eased off?

I'm panicking because I'm with PUK and their titration is so short I feel like I can't move onto anything else (ie atomoxetine if needed)

So I'm on day 19 of titration. My original schedule was:

30mg 1 week

50mg 1 week

70mg onwards

After a discussion with my prescriber she allowed me to have 40mg on week 2 but when it got to it I thought I'd try 50mg as originally suggested and it gave intense nasal congestion.

She called me and offered me 30mg caps and 20mg caps to "play around with lower doses" which I really felt great about.

But when I was on 40mg for a week I was drowsy the entire week and thought maybe my dose is too low and what if 50mg would work now. I took 50mg yesterday and was absolutely zonked. No energy or motivation whatsoever (no congestion either though so that's good)

So after messaging my prescriber, I decided to try 30mg again today as it actually worked ok for me.

But by 4 hours after the dose I felt like I did pre medication and now I'm so tired.

I know nobody has probably done this sort of thing but can anyone give me success stories with titration and similar reaction (drowsiness at a higher dose)

So I'm being titrated on Elvanse. My original plan given was 30mg week 1, 50mg week 2 and 70mg week 3 onwards.

My initial thoughts were this seems very fast. I am prone to some anxiety so was worried it would increase this

I broached it with my prescriber and she said (after some persuasion) that seeing as she's given me 20mg caps for when i move onto 70mg (to take alongside 50mg) I can take 2 of those week 2 and just to let her know when I start so she can send more 20s.

30mg did sort of help but nothing major so I'm wondering if I should just go to the 50s straight off but I don't want to be wired. I start them today but I am home alone with my 4 year old so I'm conscious of how it will affect me.

What was your experience with titration?

Update:

My prescriber called me after I messaged her this morning because I had nasal congestion around 3 hours after taking 50mg. She was really nice and said that yes it is a side effect but it's a rare one (she even said nobody she's prescribed it for has ever had it!). She said to go down to 40mg tomorrow and shes gonna send me 28 20mg caps and 28 30mg caps so I can play around with lower doses to see what works best.

I am so so relieved with that because I think I was panicking about the overall titration plan and now I can relax more.

Thank you to everyone for your input

I don't know if this has already been posted but I know I was searching for ages when I was waiting for titration, as it can feel endless. So here's my experience, with dates.

I was diagnosed 10th May 2025.

I got my blood pressure monitor around 25th June 2025

Between then and titration heard nothing unless I contacted them. Which I think is normal for PUK (apart from newsletters)

The wait for titration increased over the year from 7 months, then to 10 months then to 10-12 months. You will be waiting the amount of time that it currently is, not what it was when you were diagnosed (I asked PUK about it during my wait).

I got the "you're approaching the top of the list" note on 12th May 2026, so a year and 2 days after I was diagnosed.

I filled out the forms that same day and received a note on 22nd May saying that an allocated prescriber would be reviewing my file and contacting me within the next few days.

I contacted PUK around 14th May 2026 to see how long it would be before I heard from a prescriber, after I'd received the approaching note. They said they had requested my up to date GP records and were waiting on them.

I chased that with my GP a couple of times but I don't know if that sped anything up.

The prescriber contacted me on 27th May and discussed titration. Their pharmacy received my prescription 1st June and it was delivered by DPD 3rd June (but I started the medication on the 4th so that I took it first thing in the morning).

Hope this helps anyone who is waiting, to know how long it MIGHT be. Obviously this is just my experience at the current wait time.

I'm in the UK (England) and I've worked for my employer for 9 years. I have been off sick for mental health reasons due to ADHD. While off sick, my manager has told me that the new area manager has removed me from the 2 stores I work at and has said I need to move stores (due to the stores being over their staffing allowance).

I currently/did work at 2 locations due to there not being enough hours at my original store when I came off maternity leave 3 years ago so had to split my days between 2 locations. (I realise now this is sort of the second time this has happened while I've been off work.)

She has suggested a store which is within reasonable travelling distance, however the hours I am available to work don't seem to suit the new store. I told her I can accommodate her in that, when I work during term times I need to work school hours and in half term I can work full days (which is what she wants). What will happen if she decides that's not suitable and I have essentially not got a store to go to when I return from sick leave?

I am happy to move stores realistically because it's the same job and I don't work full time. But the more I think about it the more I wonder if I should have had a conversation before being *told* I'm "not allowed to go back to either store"

Am I just being dramatic or is there something I can do here?