Relationship Partner with BPD (Straight and LGBT+) => Romantic Relationship | Bettering a Relationship or Reversing a Breakup => Topic started by: Okabedrpepper on March 03, 2021, 04:21:01 AM

Title: BPD and Vyvanse
Post by: Okabedrpepper on March 03, 2021, 04:21:01 AM
 My girlfriend (recently diagnosed with BPD) has had a problem with focus, tiredness, and fatigue her entire life. Years ago she was diagnosed with ADHD and started taking ADHD stimulant meds which helped her have a life by being able to be awake enough to do a job.
 Prior to her diagnosis she was very agitated and threw away her Vyvanse because she thought it was making her anxiety worse. She had a bad episode around that time and ended up in the hospital which is when she finally got her diagnosis of BPD.
. After she got out, her psychiatrist tried her on Modafinil which didn't work and gave her bad stomach issues. So she went back to Vyvanse so she would be able to work. I know that she has been taking one to two extra a day recently that has been jacking up her anxiety and worsening her mood and causing splitting to be worse.
 I need to convince her that the Vyvanse is making her life more difficult right now.
 Has anybody had an experience with ADHD meds or with perpetual tiredness with their partner who has BPD? What worked? What didn't work?

Title: Re: BPD and Vyvanse
Post by: Ou812 on March 11, 2021, 02:29:50 PM
That's a tough one and while I can't give any advice I want you to know your not alone. My wife got diagnosed a year ago with BPD and ADHD and got on it and it's a blessing and a curse. While she is less depressive/lathargic she is also quicker to anxiety induced anger  and even when she is happily excited - it's intense. Worse my son was diagnosed with BPD and I recently learned she had been giving him Vyvanse and my son asked his doctor for a prescription and the doctor said no, that BPD and Vyvanse are a bad combo. Since my son has found ways to get it and is now abusing it. So frustrating. Hope other people post on your question and wish you well on your journey.

Title: Re: BPD and Vyvanse
Post by: bpdgourmand on March 11, 2021, 06:53:40 PM
This is a tough one. My wife's adventures with prescribed stimulants have been seriously problematic, and are an ongoing concern, but she is still taking them and they do help with the executive functioning.

Here's what I've found:
- She does function much better while on a stable dosing schedule.
- Stimulant withdrawal, on the other hand, is an abject nightmare for both of us, and she will straight up abandon basic human self-care, and concern for her children, when this happens.
- For whatever reason, only the amphetamine class of meds (like Vyvanse) work without inducing rage and general meanness, or frank paranoia.
- Every time her dose has been increased from a previous plateau, there has been some increase in meanness and paranoia until she adjusts.
- She is absolutely dependent, and possibly it is fair to say, addicted. 

Fortunately, she is too fearful to resort to seeking out illegal drugs, so that has never happened.  She will go across state lines to get OTC pseudoephedrine to supplement her prescription, and this is generally a bad time.

The issue of staying on a stable dosing schedule has been a longstanding drama, and seems to have been one of the ways my caretaker-ness has been tested and measured.

Since the amphetamines are a controlled substance, P-docs can only prescribe 30 days supply at a time.  My wife developed a routine of blowing through her month's supply too quickly.  So, we had this weird monthly cycle of: Two weeks of high energy, getting a lot done, but proneness to rage and general jerkiness.  Then there would be two weeks of depression, uselessness, neediness.

At some point, I found myself in the role of managing all of her medical, prescription, vitamin regimens, etc.  I couldn't do it, and set a boundary there, saying she needed to handle her own medicine like an adult... Or we had to admit she had a drug problem and needed to be monitored as a person who could not be trusted. 

A worsening of the 2-week on/off cycle thing was a response, I think, to my refusing to manage the three times per day she was meant to take her pills.

Now this issue happens to a lesser extent, and rarely. After staunchly refusing to manage her meds (unless we were saying that she could not be trusted to physically handle the meds,) she eventually settled into a somewhat responsible, self-directed regimen.... but there was one very dangerous, scary incident that followed after a period of stability.

She had a P-doc (and me) convinced that her diagnosis was could be completely described by ADHD and PTSD, and that her issues were simply requiring better medicating/handling of the ADHD.   So, after some failed experiments with other typical ADHD meds, the P-doc put her back on the amphetamines, and added Venlafaxine and Mirtazapine to the mix. 

I have learned that this trio is called "California Rocket Fuel" and is only indicated for severe, treatment-resistant depression.  It was a phenomenally bad idea.  Wife had a full-blown manic episode that got her misdiagnosed as Bipolar, and resulted in her parents coming to stay with us and me going on FMLA. (Wrong "BPD" it turns out.) 

Anyway, the P-doc that prescribed that combo was at fault, ultimately.  That P-doc was not typically reckless, though, and it should be noted that my wife must have had a hand in making that doc risk her own license with this idea. 


Long story short, the stable dosing seems to be helpful, but that is a path with many dangers, and I am not sure I can recommend the best way to avoid the dangers.