I have been on adhd meds for 4 half years.vyvanse (lisdexamfetamine) 70mg a day. now on prozac which i like but didn't work at 10mg so now on 20. week later, vyvanse (lisdexamfetamine) only lasts 6hrs. wht is best action w/o lower prozac?

You can: Take two doses of Vyvanse (lisdexamfetamine) at 40 ng in the morning and 30 mg at noon. The Prozac should not affect the Vyvanse (lisdexamfetamine) at all. See your doctor and discuss your problem and see if changing the dosage and scheduled time will work.

Raise Vyvanse (lisdexamfetamine): Speak to your prescriber about increasing the dose of Vyvanse (lisdexamfetamine). Although the largest capsule is 70 mg, it is not uncommon to exceed that as long as you dont have symptoms of over dose. this should increase the duration of Vyvanse (lisdexamfetamine).

Stop Vyvance: I suggest you stop Vyvance and use Adderall (dextroamphetamine and racemic amphetamine) short acting medication to use at the right times for you and your daily schedule.

Reassess: Not clear why after 4 ½ years you added Prozac (fluoxetine) and how you think it's helping. Suggest you carefully review with prescribing doctor or psychiatrist to decide what's best. Also, there may be some drug interaction at play. I hope this helps.

Possible change : Vyvanse (lisdexamfetamine) (and other adderall like medications) and Prozac both interact with an enzyme in the body called cyp2d6 which may affect the consistency that you previously noted with vyvanse (lisdexamfetamine) (although in this case theoretically may stay in the system longer and not shorter). One option would be to change Prozac to a different ssri or augment with IR stimulant or change to a methylphenidate stimulant

Consider switching: Hi Josh, there are other serotonin medicines that might work for you and not change your vyvanse repsonse. consider also zoloft, celexa, lexapro (escitalopram) for instance

Keep a journal: Hi, the first step to your problem is to assess the response to meds with more precision. Please keep a journal of your response to meds for a couple of wks and then discuss it with your MH provider. also , journal those situations that you have difficulties in handling. Changing meds regimen is c complex task and needs to take into account contextual factors.