Hi everyone

My gf has been on vyvanse (elvanse in EU) for a few months (now on 60mg) and even though she’s had a positive effect in terms of motivation, energy etc her anxiety, stress and emotional disregulation also skyrocketed 🙁

We have read many good things about combination therapy with strattera and intuniv, although unfortunately the latter is unbelievably difficult to get prescribed in Denmark and even more difficult to get it via the social security system.

Now she just started on strattera 18mg with her vyvanse at the same dose 60mg. I assume it’s just for assessing the side effects since I read that the starting dose for strattera is 40mg for adults. So far she’s on day 4 but she’s not yet feeling anything positive as I believe it takes time to build up in your body, however she’s sweating more and her anxiety has also increased (also higher heart rate).

The psychiatrist from the ADHD clinic she was diagnosed was only supposed to start her on it and then has to end her over to a 3rd party psychiatrist and he was against combination therapy with strattera or intuniv but open to typical anxiety medications🤷🏻‍♂️

Her current one isn’t an expert on ADHD but is open to it and she’s a lot more open minded and helpful. I wonder however if once started on strattera she should have had her vyvanse dose lowered and the strattera increased like : strattera 40mg and vyvanse 50mg or 40mg.

How does a typical titration protocol looks like when moving someone from mono therapy to combination therapy? Experiences ? Thoughts?

Any hep is highly appreciate.

Note: she tried phenidatdes in case you ask and they weee absolutely horrible for her.

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