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What Causes Severe Anxiety Despite Taking Vyvanse?

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Posted on Sat, 16 Jul 2016
Question: My 27yo daughter has taken levothyroxine 88mcg x17yrs and Vyvanse or other stimulant for 11 yrs since she sustained a closed head injury, mild-moderate. She has also stopped her Meds periodically because she's young and irresponsible. She restarted Vyvanse 50mg last XXXXXXX And started being very anxious with occasional episodes of extreme anxiety. The anxiety eventually resolved. She has never had anxiety like that before, but has had anxiety on Vyvanse before. She restarted levothryroxine 5 months ago and was asymptomatic. In March, she started Junel BCP.She called me today saying that she has been having severe anxiety, OCD symptoms, and panic.
Last July, she started having her first adult relationship. In a joint decision, She moved to WAsh. DC where he
lives. They just rented an apt. where they will be living together. She's very excited but hadn't wanted to live with anyone without being engaged. She gave in to his wanting to live together before engagement, but says that she really wants to live with him. Recently, there has been a lot of stress between his close friends' wives and my daughter.
While clearly there are psychological and social issues now, she and I question whether the meds, and interaction between them could be contributing/causing her extreme anxiety. Again, she has never been particulaly anxious or has OCD symptoms before.
THank-you.
doctor
Answered by Dr. Alexander H. Sheppe (9 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

It could be that her anxiety is entirely related to the considerable stresses in her life right now. However, your idea that medications could be contributing could be correct. Both Vyvanse and levothyroxine can individually cause anxiety and panic, and the risk is doubled when taken together. She should get her thyroid levels rechecked, and seriously consider stopping the Vyvanse. These two things would be important considerations to getting her anxiety under control.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Alexander H. Sheppe (43 minutes later)
She was told by here NP that her thyroid levels are WNL, but I don't know what specific tests were done. The NP also said that if she didn't take the levothyroxine on an empty stomach, they don't do anything. She had typical physicals xs of hypothyroidism when off the meds and doesn't now.

She has taken both mess before without problems. She needs to be on a stimulant for ADD, which she started experiencing after a CBI 11 yrs ago.

From what I read, Junel can cause severe anxiety. Have you seen that? Do you think that there could be some kind of interaction between the 3 meds exacerbating some relatively anxiety that she has from all the stress going on?

In the last year, there has been a tremendous amount of stress with the rest of the family, which I'm sure on top of everything else could be impacting her now. However, I wouldn't want to miss any drug S.E. Or interaction making everything worse.

doctor
Answered by Dr. Alexander H. Sheppe (10 minutes later)
Brief Answer:
Followup

Detailed Answer:
Junel can rarely cause anxiety, but much more likely is the stimulant Vyvanse is causing it. I would seriously re-evaluate the need for this. She can also consider cognitive behavioral therapy if she wants a non-medication option for treatment.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Alexander H. Sheppe (33 minutes later)
THank-you for your answers. I thinks that CBT would be helpful and perhaps mindfulness. SHe might also do well with a psychoanalytic oriented psychotherapist. I's try the CBT and mindfulness first.

THank-you. You've made me think about the whole picture, especially Realizing that all of the issues that did and still are going on in the past year have had a big influence on her.
doctor
Answered by Dr. Alexander H. Sheppe (1 minute later)
Brief Answer:
Followup

Detailed Answer:
Sounds like a good plan. You are most welcome!

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Sonia Raina
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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What Causes Severe Anxiety Despite Taking Vyvanse?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. It could be that her anxiety is entirely related to the considerable stresses in her life right now. However, your idea that medications could be contributing could be correct. Both Vyvanse and levothyroxine can individually cause anxiety and panic, and the risk is doubled when taken together. She should get her thyroid levels rechecked, and seriously consider stopping the Vyvanse. These two things would be important considerations to getting her anxiety under control. Please remember to rate and close this answer thread when you are finished and satisfied. In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers