FilmGuy, what anti-depressant are you on? So did you get a chance to stabilize on that before adding the Vyvanse? I think it is really good to just add one med at a time, even if it seems the slow approach. Since you had the headaches whether you took the Vyvanse or not, maybe the problem is actually the anti-depressant and not the Vyvanse.

I take Bupropion and Vyvanse and was started on 30 mg, a very typical dose. (I think it is a really good medication, by the way--very smooth, not jolty coming on to it, and not prone to abuse.) Later I felt 30 mg might be too much so I asked for a 20 mg prescription. I now have alternate prescriptions when I get them filled: one month 20 mg, one month 30 mg. And I take the amount I feel I need that day. Many days I only want 20, but the truth is, I probably do better on 30. But I like 20. You will get to know what works for you. A big problem for me is that I often forget to take it in the morning, and then past a certain point in the day, it's hard to take because it will keep me up at night.

To know what dose to take, your prescriber will probably give you the behavioral surveys (ability to focus, complete tasks, etc.) and compare your ratings before and after. If your symptoms are not being adequately controlled, she may increase the dose. that is what mine did. It helped her decide to escalate from low Bupropion to high Bupropion, and from there to Vyvanse + hi Bupropion, and from there to Vyvanse + lo Bupropion. It takes a bit of experimentation. Also you can monitor if your dose is too high if you are having trouble falling asleep at night, if you feel too "up" such as feeling boundless energy, talking too much and too fast, feeling impatient with people because they seem to be reasoning or talking or moving too slowly, etc. (If I take too much stimulant, the "slowness" of other people can annoy me.) You will find after a while that you know what the right dose is.

I would recommend to you that you get your AD sorted out by itself so you can figure out the headache issue. (This might not be the right AD for you.) Then add the Vyvanse. To increase from 30 mg to 60 mg sounds like a huge increase to me! According to my PNP, some people with depression who are on stimulants may not also need an AD, because stimulants can help with depression.

Good luck! Go slowly.