Question: Hi I have add and take vivanse 70 daily, which uauLLY EORKS WELL but it only last 4 Hours then ir poops out. I work in v busy psych admissions unit and have to take th vyvanse around 12-1pm to get it to last halfway through th shift. which is around 5-6 (variable) Obviously I have called the geniuses at shire but this was a non-starter- they have info but would't tell me squat. And I had several cogent questions, esp to do with absorption and how to get reliable effects. the kicker is that I have a fast metabolism cytochrome p450 and some others- the testing revealed that "these drugs may not work as intended." So my doctor added dexedrine ,dosage now30 mg bid> These last about2 hours and I may repeat x1, after the vyvanse wears off. I could take the vyvanse later, maybe4-5pm and this might suffice but no sleep. g The lunesta 3mg isn't cutting it, I also take clonazepm 2 mg at bedtime, around 1-2 am, but this also isn't working. we've discussed using ativan instead but haven't done it yet. I actually had the best result in taking vyvanse 100 mg. As I increased dose this was XXXXXXX I noticed it worked longer, which actually shouldn't be the case- just a higher peak. But to do this I have to pay cash , they won't approve > 70. I even protested and one of their (from fed bc &bc?) own bathed angrily to my psychiatrist! /So he then added the dexedrein., what should I do about sleep? Thats my main concern right now. Dex is only for working pms-12 days/ mo; allso on duloxetine 60 daily. oxcarbazepine,375 at bedtime, losartan 25 daily , parotonix 40 qd am(gerd), and methylfolate ~ 8 mg qd. Split doses on vyvanse didn't really help but is possibility. If I took ~30mg at noon at 40 and 40 mg at 6p. I need a stronger sleeping pill, can't take ambien how about --- what ,? restoril? I am 63, reasonably good cond. Also the possibility of "just getting sleepy and non-functional occurs but I think I would be fired. Sorry about the typos, I prob. left a few things out but I have to got wok today and I'm late!

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