Okay basically my medications are working. I think. I mean when I take them together, all the time, things are okay. But there's this funny problem...Remeron/Mirtazapine makes me REALLY GROGGY. Which is okay when I am taking the Vyvanse, which perks a person up rather nicely (even while calming the brain). But there are days when I don't really need to take a stimulant...and I HAVE to because otherwise I will sleep all day. I'm honestly a little annoyed with my prescriber right now because YES, I get it, he is probably used to working with people who are a little less meticulous about self-reflection and a little more likely to give in to ADHD impatience. I'm not one of those people, I have a pretty good idea of when I'm being driven by impulse and when I've really analyzed the criteria and am making a reasonable request.
I analyzed these criteria months ago when I started the Remeron...this is a known side effect that should have gone away by now. It is not typically an issue, because I like taking my stimulant most of the time anyway, and the days when I choose not to take it are ones where I don't really need to think. But yesterday, I forgot to take the stimulant...and was SCREWED at work. I was fighting to stay awake all day...it was awful. I'm just lucky I was at the job where I don't need to be "on" all the time.
When I called him he said "oh...just take it in the evening". I already do. So he said "oh. Take it earlier in the evening". I said "I get what you're saying, but if you look at this logically, it's 6pm right now as I'm talking to you...I should not still be THIS groggy and I have been THIS groggy all day". He said "okay, I hear you, just try it and call me next week and it it's still a problem we'll try something else".
UUUUUUUUUUUUUGGGGGGGGGGGGGGGGGGGHHHHHHHHH. Oh I'm going to try it. I'm going to do it to the LETTER because there's no way in hell I'm going to have him disagree with me next week.
Last night, as instructed, I took the medication two hours earlier, AND went to bed earlier, just to make damned sure that lack of sleep wasn't part of the problem. I could hardly wake up this morning and instead of taking the Vyvanse, I went to work without it because of course, if I take the stimulant I won't be able to tell if I'm still groggy from the Remeron. My boss come into the office and asks me if I'm popping quaaludes...no, I am NOT JOKING. When I say groggy, I mean god damned groggy. I was working not to slur and struggling to stay away. I waited until two hours after I'd woken up and took the Vyvanse...which takes another 40 minutes to kick in, which means I lost an entire morning before I could even sort of function at work.
UNACCEPTABLE.
We're trying something else cowboy. I have way too much at stake, and WAY too much to catch up on due to medication drama earlier this year, to be knocked out like that!
I am beginning to wonder if the Vyvanse is actually doing what I need it to do, or if I'm just so relieved to cut through the fog of the Remeron that I'm giving it way too much credit. To the Remeron's credit, it sure gets rids of my anxiety!
It is true that while the Vyvanse makes me very effective at getting some things done, I am still struggling at some things...although when you look at it...I am able to focus damned well on things I enjoy, even more so then when I wasn't taking it...before I started taking it even if I enjoyed something I would be distracted still. Now...if I like something I can do it for hours. But if I don't...I'm even less likely to do it. Because I am so able to focus on the things I like...ugh...that damn line between "is this med working" and "oh, I need to pull my head out of my ass and do some boring crap right now" is sooooo thin...too thin...which I guess is why ADHD is a disorder, not a "gift"....
I analyzed these criteria months ago when I started the Remeron...this is a known side effect that should have gone away by now. It is not typically an issue, because I like taking my stimulant most of the time anyway, and the days when I choose not to take it are ones where I don't really need to think. But yesterday, I forgot to take the stimulant...and was SCREWED at work. I was fighting to stay awake all day...it was awful. I'm just lucky I was at the job where I don't need to be "on" all the time.
When I called him he said "oh...just take it in the evening". I already do. So he said "oh. Take it earlier in the evening". I said "I get what you're saying, but if you look at this logically, it's 6pm right now as I'm talking to you...I should not still be THIS groggy and I have been THIS groggy all day". He said "okay, I hear you, just try it and call me next week and it it's still a problem we'll try something else".
UUUUUUUUUUUUUGGGGGGGGGGGGGGGGGGGHHHHHHHHH. Oh I'm going to try it. I'm going to do it to the LETTER because there's no way in hell I'm going to have him disagree with me next week.
Last night, as instructed, I took the medication two hours earlier, AND went to bed earlier, just to make damned sure that lack of sleep wasn't part of the problem. I could hardly wake up this morning and instead of taking the Vyvanse, I went to work without it because of course, if I take the stimulant I won't be able to tell if I'm still groggy from the Remeron. My boss come into the office and asks me if I'm popping quaaludes...no, I am NOT JOKING. When I say groggy, I mean god damned groggy. I was working not to slur and struggling to stay away. I waited until two hours after I'd woken up and took the Vyvanse...which takes another 40 minutes to kick in, which means I lost an entire morning before I could even sort of function at work.
UNACCEPTABLE.
We're trying something else cowboy. I have way too much at stake, and WAY too much to catch up on due to medication drama earlier this year, to be knocked out like that!
I am beginning to wonder if the Vyvanse is actually doing what I need it to do, or if I'm just so relieved to cut through the fog of the Remeron that I'm giving it way too much credit. To the Remeron's credit, it sure gets rids of my anxiety!
It is true that while the Vyvanse makes me very effective at getting some things done, I am still struggling at some things...although when you look at it...I am able to focus damned well on things I enjoy, even more so then when I wasn't taking it...before I started taking it even if I enjoyed something I would be distracted still. Now...if I like something I can do it for hours. But if I don't...I'm even less likely to do it. Because I am so able to focus on the things I like...ugh...that damn line between "is this med working" and "oh, I need to pull my head out of my ass and do some boring crap right now" is sooooo thin...too thin...which I guess is why ADHD is a disorder, not a "gift"....
There is a class of medications known as alpha2 receptor stimulants. A new long acting one called Intuniv was just released in mid November of this year. It works in the prefrontal cortex and may improve depression and axiety as well as inattentiveness and impulsivity. I have a new blog which is mostly about the inattentive type of ADHD. I have written a description of how this medication works. If you take the Intuniv, you would stop the Remeron but you could continue the Vivanse if needed. You are SO RIGHT, the Remeron should not be making you THAT sleepy. I work in an Emergency Room where I see boat loads of people on the SSRIs (Prozak, Paxil, Remeron...), the level of sedation that you are describing is not an acceptable side effect. Ask your presciber about switching to Intuniv. If they do not know about it, get a new prescriber.
ReplyDeleteTess http://primarilyinattentiveadd.blogspot.com
Wicked, I will totally check out your blog! This seems to be the dance that my prescriber and I do...he always has to "test me" once and then will usually be more flexible, lol...he's pretty up on newer medications too, I'll have to ask him about this one...hmmmmm! But I did realize that I have a few more assignments to turn in before I officially graduate so I think I'm going to hold off on big changes in the meds until next month!
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