Had follow-up with ADHD med provider earlier today. Went very positively.

Sticking with split dose of lisdexamfetamine (Elvanse) at 40 mg then 20 mg (~2 hours apart) daily.

Increasing guanfacine (Intuniv) dose from 4 mg to 5 mg nightly.

The imbalanced lisdex dose is helping more with giving us more of a morning boost, whilst letting us wind down faster in the evenings.

The guanfacine is continuing to help with RSD and baseline anxiety. Also counteracts the increased heart rate and blood pressure of the lisdex.

The meds aren't a miracle fix for everything AuDHD related, but they make it possible to function during continued burnout... and that's saying something.

#ADHD #AuDHD #lisdexamfetamine #Elvanse #guanfacine #Intuniv #neurodivergent #neurospicy #neurodivergence #neurospiciness #AuDHDBurnout

We've been on a split dose of lisdexamfetamine (Elvanse) daily for a while now. This has involved 2 x 30 mg doses, typically between 90 to 120 mins apart.

As of today, at our request, we're trialling a split dose where we start with 40 mg, then follow that with 20 mg within the same approximate time window.

The hope is that this will help give us a little bit more of a quicker boost to focus in the morning, whilst giving us a bit more of a drop-off in the evening.

We're also still on guanfacine prolonged release (Intuniv) nightly alongside the lisdexamfetamine, which has honestly been fantastic for us as an AuDHD entity with intense anxiety and RSD. We're currently on 4 mg of this night, but hoping to increase it to 5 mg soon.

Based on our own research and experience, somewhere between 4 and 6 mg should be ideal. 5 or 6 mg will likely be the sweet spot.

Per previous posts we've done, it took a lot of persuasion and self-advocation to convince our UK ADHD healthcare provider to even let us have a split dose of lisdexamfetamine, let alone convincing them to prescribe a combo of complementary meds, since both are unlicensed (aka off-label).

If you want to do the same, we recommend preparing links to articles or resources showing:

• The benefits of a split dose.
• The benefits of a combo of meds.
• The known interactions between such meds, such as via a drugs interaction checker.

You should be prepared to:

• Be advised that they may need to discuss this further, rather than agreeing immediately.
• Be told that they can only make one change to your medication at a time.
• Advise them in detail why you are making this request, from a neurodivergent and mental health / wellbeing point of view.

If you're asking for a combination with guanfacine, you may need to traumadump / mental-health-dump (after asking for consent) in order to persuade them to trial the meds.

It's not easy, and you'll need to be as kind as possible at all times to get them on your side, but it is possible to get what you need if you get an empathetic and caring clinician.

The above might sound manipulative, but this is what self-advocation can look like sometimes. It's a mixture of letting the mask slip a bit to be emotionally honest, employing rhetorical techniques, and being kind and polite at all times.

It's not easy, even if you're good at all of those things.

You can always request permission for an advocate on any calls or appointments with you to help.

#ADHD #AuDHD #lisdexamfetamine #guanfacine #Elvanse #Intuniv #neurodivergent #neurospicy #neurodivergence #neurospiciness #SplitDose #ComboMeds #MentalHealth #anxiety #RSD #RejectionSensitiveDysphoria

NGL, it's honestly kinda funny to us that there was such resistance to the very concept of us taking a combination of meds to help us with our ADHD (tecnically AuDHD) struggles, given that the meds don't have any known negative interactions and actually cancel out some of the negatives of each other 😅

e.g.,

Lisdexamfetamine (Elvanse®)

• Insomnia or disturbed sleep
• Increased blood pressure
• Increased pulse

Guanfacine (Intuniv®)

• Drowsiness
• Decreased blood pressure
• Decreased pulse

We're up to 4 mg of guanfacine nightly now (as of Monday), alongside 60 mg lisdex (split across 2 x 30 mg doses, taken ~2 hours apart) daily.

Aside from some minor titration issues whilst our body has been getting used to the introduction of guanfacine, we've found it is beginning to help with sleep and has noticeably helped lower our blood pressure and pulse.

It's also having the pleasant effects of reducing baseline anxiety, which is a key component of our Rejection Sensitive Dysphoria (RSD), and lowering our disgust reflex, which became more prominent during the summer and which we think is a major factor in the increasing ARFID-like symptoms we experienced (and are still trying to recover from).

Unlike with SSRIs or SNRIs, it doesn't make us feel numb or unable to feel sad. That makes sense, as it's basically selectively blocking some alpha-2A adrenergic receptors, which in turn is decreasing activity within our sympathetic nervous system.

If we continue to do well at 4 mg, we'll probably ask to remain there, rather than trial going higher, as 4 mg seems to be the sweet spot for a lot of folks, and is the max dose of a single pill. We could in theory try up to 7 mg, but we're not in a rush there.

#guanfacine #lisdexamfetamine #ADHD #AuDHD #anxiety #RSD #ARFID #SideEffects #neurodivergent #neurospicy

My #tics related to severe #tourettes have changed since I stopped using #GabAPentin as a way to manage them.

Before they were subtle, but almost never stopped as they were impossible to fully satisfy. They were smaller movements or twitches that were very frequently.

I switched to using a higher dose of #Guanfacine which is an #adhd and tic specific medication, and now they come in waves and are more forceful, and harder to contain.

But I can actually have some peace.

#writing #neuroscience

Hey folks  

Our titration on guanfacine prolonged-release (Intuniv) tablets is going broadly well. We have been, and still are, experiencing side effects, but nothing typically that we didn't expect.

We completed our first full week on the guanfacine last week, taking 2 mg nightly, and started taking 3 mg nightly on Monday this week.

We're taking the guanfacine alongside lisdex (Elvanse), which we're presently still taking as a split dose (2 x 30 mg capsules daily; each capsule taken ~2-3 hours apart).

The positive effects for us so far have been:

• Lowered anxiety.
• Lowered RSD.
• Slightly lowered threshold for initiating a task we don't want to do.
• Slightly better sleep hygiene (due to slight drowsiness).
• Lowered heart rate and blood pressure.

The certain side effects so far have been:

• Increase in wind (flatulence).
• Change in toilet schedule.
• Drowsiness (especially upon waking).

Something we're monitoring to determine whether it's an effect of the meds, perhaps directly or indirectly, is that we've experienced a few instances of intense, explosive (but very directed) rage  

These appear so far to be linked to trauma and/or neurospicy triggers we have, rather than just anything, but we're not sure yet.

e.g.,

• Accessibility issues with the NHS and DWP.
• The mind-boggling complexity of mattress hunting, due to:
  • Dodgy mattress companies.
  • Fake (or paid for) review websites.
  • AI chatbots answering email queries!!!
  • Legit companies only selling products in stores, and providing e-tailers with bespoke mattress types which therefore cannot be directly compared without spending hours making a detailed spreadsheet, cracking the jargon code, and finding section diagrams.
• Smart devices randomly playing music, despite no-one using their wake word and no-one saying anything like that.
• Cold-callers not being able to read the "no cold callers" sign.

It's not clear whether the outbursts are:

• a side effect of the guanfacine.
• an indirect effect of the guanfacine.
• unrelated to the guanfacine.

We objectively have a lot of stressors in our life, and part of how our mind has dealt with them has been to not focus on them.

Counterintuitively, it's likely that being able to function more has meant we've had to start addressing more issues, which has increased stress in other ways.

It's overall still a massive improvement, and we do feel calmer overall, plus we'd have had to deal with all the same issues anyway eventually. It's probably largely just a matter of managing overwhelm as best as we can.

Plus we're still waiting on the NHS to offer us mental health support, which might -- in the long term at least -- help with some of the triggers... maybe 🥺

#ADHD #AuDHD #neurospicy #neurodivergent #guanfacine #lisdexamfetamine #ExecutiveDysfunction #anxiety #RSD #NeurospicyRage #NeurodivergentRage

Fedi date, erm, Thursday 2025-10-30.

Taken a 2 mg pill nightly on Monday, Tuesday, and Wednesday.

This is alongside our daily lisdex totalling 60 mg, split across 2 x 30 mg doses, about 2 hours apart.

Executive function is a little down, we're feeling eepier, and we've had some mild gastro-intestinal grumbles, which seem to be fading. Perhaps a little more headachy, but not 100% that's due to the guanfacine.

Baseline anxiety and RSD are both down. Less jitteriness too, but also been clumsier. (In fairness, we probably have undiagnosed dyspraxia 😅) Disgust reflex (from icky stuff) is also reduced, and task initiation has been a little bit easier.

Headmate Hannah got the giggles first, and now they've mildly spread to the core (Evie) too.

Will keep you all updated.

#ADHD #AuDHD #lisdexamfetamine #guanfacine #neurospicy #neurodivergent

Started guanfacine last night at 2 mg. Just took second nightly tablet.

Too early to tell if it's working fully, but currently feeling a little less anxious and jittery.

Also feeling generally sleepy, despite a total of 60 mg lisdex daily across 2 doses, but not necessarily in a bad way.

Feels positive overall so far, but very early days.

#ADHD #AuDHD #guanfacine #lisdexamfetamine #neurodivergent #neurodivergence #neurospicy

Since our latest ADHD prescription meds finally arrived on Saturday, we're officially starting guanfacine tonight at 2 mg nightly.

This will be alongside our 60 mg lisdexamfetamine daily dose (split across 2 x 30 mg capsules, taken about 2-3 hours apart).

The hope is that it will help us with intense RSD, anxiety, and some of the jitteriness we get from the lisdex.

Obviously we'd rather not get any of the awful potential side effects, but we'll just have to see what happens. If we do get them, it would be ideal if any side effects are limited mostly to titration  

Gonna take first dose now, alongside our normal night-time stuff, and start preparing for sleep.

Fingers crossed 🤞   

#ADHD #AuDHD #lisdexamfetamine #guanfacine #RSD #neurodivergent #neurospicy

New prescription arrived this morning 🥰

We'll be starting the guanfacine Monday night, as Monday is the beginning of a week in the UK and -- for highly-neurospicy reasons -- we need to start any regular medications on a Monday (the start of the week).

We're aware that the order of the days of the week don't make any logical sense, but we live in a country that follows the ISO 8601 weekday order, which means weeks starts with the moon and end with the sun.

Also, yes: we're aware we're likely OCD too, but we can't really do anything about that right now 😅

Someone should really redo the weekday, as well as the entire Gregorian calendar, to make them make actual sense.

#ADHD #AuDHD #guanfacine #lisdexamfetamine #RejectionSensitiveDysphoria #RSD #anxiety #EmotionalDysregulation #ExecutiveDysfunction #neurodivergent #neurospicy #ProbablyOCDTooTBPH