Navigating Addison's Treatment: Concerns about Vyvanse and Mental Health
I'm a 31-year-old dealing with ADHD and a background of depression, currently managing my symptoms with a daily dosage of Vyvanse ranging from 30 to 50 mg. This past weekend, I received a diagnosis of Addison’s disease (Primary Adrenal Insufficiency) following an adrenal crisis that necessitated my admission to the ICU. Although I have been discharged, I am left with several questions and would be grateful for any insights. Currently, I am prescribed Florinef (0.1 mg daily) alongside Cortisone Acetate, which I am supposed to gradually reduce to 25 mg in the morning and 12.5 mg in the evening. 1) **Is it safe to use steroids with Vyvanse?** When I inquired about the safety of continuing my stimulant medication, the endocrinologist mentioned they would check on this, but it seems they overlooked it by the next day. I had looked into possible interactions and found none, but the response I received suggested it would likely be fine. This made it feel like I was the one who made the decision! Can the absence of documented interactions truly indicate there's nothing to fret about? 2) **Is it common to feel worse after receiving a diagnosis?** I anticipated feeling better once I started treatment, but I’ve been feeling significantly more exhausted, even with Vyvanse in my system. Symptoms such as brain fog, mild shortness of breath, muscle soreness, heart palpitations, and sporadic flushing have set in. On the days I skip Vyvanse, I experience similar symptoms but with an added layer of lethargy, making it challenging to rise from bed. My sleep patterns have deteriorated, leading me to wake up frequently at night; I wonder if that’s a normal reaction to steroid use? These issues were absent prior to my diagnosis, making it difficult to believe that the treatment is beneficial, even though I recognize its necessity. Is it typical to experience such symptoms during the initial recovery phase after an adrenal crisis and the start of treatment? My endocrinologist indicated that increasing sodium and steroid levels should result in a feeling of improvement beyond my pre-diagnosis state, yet my current experience contradicts that. However, it has only been a week since I left the hospital—could this be a standard aspect of recovery that wasn’t adequately addressed while I was there? My mind, impacted by ADHD and depression, is on high alert, leading me to fear that I might end up with a new, intolerable norm. 3) **Could Trintellix have impacted my previously undiagnosed adrenal insufficiency? Should I consider reintroducing it?** About a year ago, I tried Trintellix for my depression with some positive results, but I had to discontinue due to significant nausea and appetite suppression, which led to concerning weight loss (10 kg). After stopping Trintellix, I actually noticed that the Vyvanse increased my appetite. Looking back, could my appetite issues and weight drop have been aggravated, or even triggered, by adrenal insufficiency that existed at that time but was undetected? Considering I am now on steroids, would it be wise to give Trintellix another go, given the steroids may mitigate any appetite issues? Additionally, are there any known interactions between Trintellix and corticosteroids that I should be aware of? My depression has been progressively worsening since I stopped Trintellix, and it seems even more burdensome since starting cortisone—though perhaps it's just the stress of managing Addison's disease that’s exacerbating it. **Edit:** Just to clarify, I plan to discuss these concerns with my endocrinologist or primary care physician at my earliest convenience. I would also appreciate any other viewpoints on this matter. I hope I have conveyed my questions clearly, despite feeling somewhat foggy-headed while writing. Thank you for any assistance! 🙏 **Summary:** Is it secure to be on Vyvanse while taking Cortisone, and is it typical to have a decline in well-being after beginning treatment for Addison’s? Can steroid use contribute to a worsening of depressive symptoms?
Answers (1)
3/20/2025, 9:20:51 AM
OpenHealth AI
It’s essential to acknowledge your concerns regarding the interaction of your medications and how you've been feeling post-diagnosis of Addison's disease. Thank you for sharing your situation; it's clear that you're seeking reassurance and clarity on several fronts.
Main Points:
- Vyvanse and Corticosteroid Safety: It appears generally safe to use Vyvanse while on corticosteroids.
- Post-Diagnosis Symptoms: Feeling worse after receiving a diagnosis is not uncommon, and some symptoms may be part of the recovery process.
- Weight Changes and Antidepressants: Past issues with Trintellix may have a connection to adrenal insufficiency, and re-evaluating its use could potentially be beneficial, but caution regarding appetite changes is necessary.
Detailed Explanation:
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Vyvanse with Corticosteroids: There are no widely reported interactions between Vyvanse (a stimulant for ADHD) and corticosteroids like cortisone and Florinef. However, both substances can increase energy levels and possibly stimulate anxiety, so it’s important to monitor how you feel. Your doctor should regularly assess your mental health, especially when starting or changing a treatment plan.
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Feeling Worse Post-Diagnosis: It is common for individuals with newly diagnosed Addison's to experience a dip in well-being initially. The body is adjusting to new medication, and the adrenal crisis may have affected your overall health. Symptoms like fatigue, brain fog, and mood changes can be part of this adjustment. Adequate rest, proper hydration, and gradually increasing your cortisol levels as advised by your doctor are crucial during this recovery phase.
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Reconsidering Trintellix: Your experience with Trintellix and its effects on your appetite and weight loss could be relevant. Adrenal insufficiency can manifest in various ways, including affecting mood and energy. If you believe Trintellix was beneficial prior to its discontinuation and you are now on steroids, discussing a potential re-introduction with your healthcare provider is wise. They can help you monitor any side effects more closely.
Next Steps:
- Track Your Symptoms: Note any changes in your mood, energy levels, and physical symptoms. This can help you and your doctors understand your condition better.
- Monitor Your Mental Health: Regularly assess how you are feeling emotionally. If you notice an increase in depressive symptoms, this should be discussed with your healthcare provider.
- Prepare for Your Next Appointment: Compile a list of questions and observations regarding your symptoms and any concerns about medication interactions so you can have an informed discussion with your endocrinologist or primary care physician.
- Healthy Lifestyle Choices: Focus on maintaining a balanced diet, drinking plenty of fluids, and engaging in gentle activity as tolerated. Make sure to have regular sleep routines to help manage fatigue and mood.
By approaching your health step-by-step and staying in close communication with your healthcare providers, you can navigate your treatment plan more confidently. Recognize that recovery often has ups and downs, but you’re taking important steps by seeking information and getting support. Please take care!
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