Switching Adhd meds + pots
Hey everyone,
Mid-thirties female here, diagnosed two years ago with inattentive ADHD. Just wondering about others' experiences with ADHD meds and POTS. I weigh 51–52kg. I've had AI help me write this out to organise my ideas better, so apologies if it sounds a bit robotic!
I was first diagnosed and started on Vyvanse. It helped a lot with emotional regulation but not much else. I also got huge cigarette cravings after starting it. I never smoked full time and was more of a social smoker when younger, but since starting ADHD meds I constantly crave cigarettes. I don't want to smoke, it's just this urge that hits after my morning dose kicks in.
I started on 20mg, then 30mg, then went up to 50mg. I had better cognitive function on 50mg but physically I felt like my body was under a lot of stress. I lost my appetite, lost too much weight (dropped to about 47kg which wasn't healthy), and had heart palpitations. I also only seemed to get about 6 hours out of it before a mood crash in the afternoon. I tried my best to eat but the thought of food made me feel ill and I'd just forget. I also gave up caffeine because coffee and ADHD meds sent my heart rate way too high (I didn't know I had POTS at the time).
I then switched to dexamphetamine, and it's definitely smoother physically with less of a crash. I take 5mg 3x per day. I got my appetite back straight away which was great, and over the past year I've put the weight back on. Still have the cigarette cravings though.
The weird thing is, dex doesn't seem to help my attention much at all. If anything, my motivation, procrastination, and distractibility feel worse. I feel more emotionally regulated but less driven and focused. On days I don't take it I genuinely can't tell much difference, except feeling sleepier. And sometimes my afternoon dose actually makes me want to take a nap, which is strange.
I've also recently been diagnosed with POTS and prescribed midodrine, so now I'm trying to work out what's ADHD, what's autonomic nervous system stuff, and whether stimulants are affecting that too. I have episodes of tachycardia during the day (picked up on a Holter monitor and BP monitor) and my heart rate shoots up to 150bpm just from standing. My POTS specialist said the dex can actually help with POTS because I have really low blood pressure. It helps with brain fog and energy, but I also feel like it might be pushing my heart rate too high, and on top of that it just doesn't feel like it's doing much for my ADHD. My POTS specialist didn't want to touch my ADHD meds and said to talk to my psych about it.
I've got an appointment with my psych in a few weeks and I'm thinking about switching to Ritalin. From what I've read about how Ritalin and dex work differently, I'm wondering if Ritalin might suit me better.
Has anyone had similar experiences with dex, made the switch to Ritalin, or navigated ADHD meds alongside POTS? Would love to hear what's worked for others.
Thanks :)