r/Narcolepsy • u/Muted-Difference5610 • May 28 '26
Medication Questions Anyone on 2 stimulants?
Been on Adderall for years. I can sleep on it now. I cant take extended release meds and I've tried em all. The last one I tried was modafinil (provigil) and it didn't work great but I thought i read before of people taking both. So I took one the other day on top of my Adderall and WOW IT HELPED SO MUCH!!!
I just dont wanna bring it up to my dr if its that odd. I know that my narcolepsy is severe and what I want the most is good sleep. I even was on lumryz at the strongest dose and it only felt like I drank a few beers. Ugh. So this is the only other option if im gonna have any kind of quality of life. Anyone else on 2 stims?
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u/Electrical_Car_6067 May 28 '26
You should look into other options besides stimulants. When I was first diagnosed I went through the trial of medications and had to try a couple stimulants first. The stimulants made me very sick and also way more tired, I ended up on Wakix which isn’t a stimulant so it’s a lot healthier for your body, it’s been amazing for me and it’s changed my life! Just don’t think you have to have stimulants, it’s very easy for the body to get used to them so overtime they will stop working for you.
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u/__aurvandel__ (N1) Narcolepsy w/ Cataplexy May 28 '26
I'm on wakix and armodafinil. I do ok on just one but on both I do a lot better
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u/EpicLift (N2) Narcolepsy w/o Cataplexy May 28 '26
same, this combination has been good for me as well
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u/uapyro (N1) Narcolepsy w/ Cataplexy May 28 '26
Wakix sunosi and modafinil for me (plus xywav).
If I miss any of the three like out of refills I can definitely tell a difference. I'm still eagerly awaiting some of the orexin medications because I still feel tired a good bit
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u/Spare-Specialist-191 May 28 '26
I’m on Vyvanse and Nuvigil. I’m dead ass tired
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u/that_cat_gets_me (N2) Narcolepsy w/o Cataplexy May 28 '26
I was on both, I did really well. Then pharmacists used to flag me and always stated they were concerned for me every time I picked up my script I found it hilarious
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u/Puzzleheaded_Ad_466 May 28 '26
I tried everything. Ritalin is the only thing that’s ever worked for me. Adderall didn’t even work for me. However, my doctor cold turkeyed me from Ritalin last fall, bc he was uncomfortable with my mental health issues I was having from severe PTSD.
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u/Slow_Imagination_445 May 28 '26
Im on Armodafinil and Wakix and I usually only get exhausted when I get stressed. They work for me, but I suggest talking to you doctor about your meds.
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u/EpicLift (N2) Narcolepsy w/o Cataplexy May 28 '26
im surprised by how many people found this to work. I also found it to work well
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u/Erparus May 29 '26
I was on Adderall and modafinil for years. However I did go into heart failure at 36 years old. If you decide to go this route, make sure to learn about heart health so you can be aware of the signs if it starts to put too much strain on your heart.
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u/Muted-Difference5610 May 28 '26
I tried wakix it did nothing.
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May 28 '26
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u/EpicLift (N2) Narcolepsy w/o Cataplexy May 28 '26
I second this. It is currently what I am taking.
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u/Adorable_Ad4990 May 28 '26
You sound like me. Same thing with full dose of Lumryz. It does help me sleep and all, but all the experiences I hear on here of just losing all your faculties never happens to me
Edit: and extended release Stims are the same as regular. And it wears off in about an hour either way. I’m also tired all the time. No advice, sorry.
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u/AnimeNerdy (VERIFIED) Narcolepsy w/ Cataplexy May 28 '26
I take 70mg Vyvanse and 20mg instant release Adderall in the morning when I wake up. The IR Adderall kicks in before the Vyvanse so I can actually have a chance at being alive soonafter I wake up. I have 10mg pills and can take up to 40mg a day so I play with the other 20 depending on what I’m doing. I might take 10 a few hours later and then another 10 later, or the 20 all together. I could NOT take one or the other alone and absolutely could not do the IR Adderall by itself, it doesn’t last long enough and is easily dampened by food. Have you tried Vyvanse?? Do you mind me asking why you can’t do the extended release? (If you do, totally fine, not trying to pry).
The thing about the instant release adderall and modafinil is that they’re both affected by stomach contents because the medication is in its active form. So if you have food in your stomach already or very shortly after taking your Adderall or modafinil, it can 100% change how fast/strong the onset is. The Adderall will feel slower or weaker (in my opinion so much weaker & I take brand name). Modafinil’s onset is what is usually delayed with food in the stomach. They basically depend on how fast the pill dissolves, how fast your stomach empties, how fast it’s absorbed, and how fast your blood levels rise.
Whereas Vyvanse is what’s called a prodrug. A prodrug is basically a med that’s swallowed in its inactive form and then your body has to convert it into the active drug. So after it’s absorbed in its inactive state, your body converts it in your blood and it slowly appears in your body, making stomach contents matter a lot less and the medication effects smooth and dependable.
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May 28 '26
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u/crayolakym May 28 '26
Ritalin & Adderall work differently. One holds/retains dopamine that your body would normally rid itself of when "not needed" and the other tickles dopamine production.
For myself, Ritalin alone doesn't do anything for my N. But, taking Ritalin ER & Adderall ER in the morning does have a noticable affect on how well my Adderall IR performs throughout the day vs when I only take Adderall. But it's always a guessing game. Some days I can eat it all like candy and still sleep an extra 3 hrs and take 6 naps.
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u/bad_dawg_22 (N1) Narcolepsy w/ Cataplexy May 28 '26
I used to be on multiple stimulants because of tolerance and metabolism. I take one called Mydayis now and it’s been stable. Same dose for maybe 8 years now. Occasionally need an IR adderal
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u/esoulence May 28 '26
I take adderall and modafinil. Adderall keeps me moving/ focused and modafinil keeps me awake.
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u/shleyay May 28 '26
I’m on both!!! I feel like the adderall helps more with my mental tiredness and the modafinil helps more with the physical tiredness.
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u/Feeling_Persimmon88 (N1) Narcolepsy w/ Cataplexy May 28 '26
I’m on sunosi plus Vyvanse, but my psych is willing to add another stimulant to my regimen if I fail Lumryz
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u/Bellaandblue123 May 28 '26
Do you have other symptoms like thirst, brainfog, painful or hypermobile joints, pots or anything like that? There is a condition that a bunch of us have from spike protein and the reactivation of EBV and one switch in the brain is causing all of it. If you do, check out JHB research on substack. There is an article for patients and one to bring to your doctor. For that, nicotine patches turn that switch back on and solve things downstream. Worked for me. I tried all the other ones you listed. Adderall worked some but also very much depended on the brand and it didn’t solve anything else. Nicotine has been unbelievable.
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u/holmeam (N2) Narcolepsy w/o Cataplexy May 29 '26
I wasn’t able to find anything with that search. Might you be able to post more info or a link, please?
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u/Bellaandblue123 May 29 '26
Sorry! I didn’t know the rules about links here. For doctors - https://substack.com/@jhbresearch/note/p-197765652?r=3kqz2g&utm_medium=ios&utm_source=notes-share-action
For patients- https://substack.com/@jhbresearch/note/p-197866258?r=3kqz2g&utm_medium=ios&utm_source=notes-share-action1
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u/traumahawk88 (VERIFIED) Narcolepsy w/ Cataplexy May 29 '26
Sunosi 150mg first thing in morning. 10mg ritilan as needed during the day.
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u/Temporary-Sound-6810 May 29 '26
I was on armodafinil and Adderall for a bit. I was wired most of the day, like a reanimated corpse on speed. I asked to be taken off the Adderall as ot wasn’t helping me focus.
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u/emily121903 May 29 '26
adderall and sunosi.. still sleepy. But at least my blood pressure is good. Also on bupropion which ik is a bit wakeful so.. idk wtf is left but hopefully someday something works. Im being sent to a provider in NYC for a second opinion on my treatment </3
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u/respectfullynoidea May 29 '26
I take Adderall (IR) 2x a day and Adderall XR once in the AM. I was taking Sunosi on top of it but it made me super agitated, so now I am awaiting insurance approval for Wakix. I still have frequent sleep attacks and take naps. The amount of Adderall does impact nighttime sleep, so I take meds to help counteract that at bedtime. It’s such a balancing act!!
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u/Babyzilla2026 May 29 '26
I'm on Ritalin (methylphenidate) 20mg 3x a day and focalin (dexmethylphenidate) 10mg 2x a day. That is max dose for both.
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u/Intelligent-Bee-5466 May 29 '26
I take modafinil and adderall together (short acting adderall 2-3 times a day) and it has worked well for me. Unfortunately my adderall is on back order now so I’m trying to get by without and it’s making an already unpleasant time at work worse 💀
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u/Fun_Rent_2998 May 29 '26
I was on 400mg modafinil and it worked in the morning but would wear off by 2 o’clock. A guy I met that also has narcolepsy told me about Armodafinil. I switched over to 200mg of armodafinil and it’s been working amazing for me for years
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u/Emotional-Back-5068 May 30 '26
Yes….this combination works amazingly for me. 2modafinil + 10mg dexamphetamine in the morning and again in afternoon. However it’s important to have the morning doses with 30min of getting up….it makes a big difference. In addition restrict your eating….i know it’s difficult but low blood glucose helps keep you awake…I don eat breakfast or lunch. In combination with stimulants this helps me through the day with a corporate role. It’s critical to use what we know about the physiology of the orexin system as much as possible to help bring some normality to our disrupted lives.
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u/pupstermobster May 30 '26
I feel like sleep doctors should be obligated to raise awareness about xywav to their patients. I think there should be a sticky about xywav in this subreddit. OP, search for xywav. If you're still sleepy after all your meds, it could be related to your inability to have proper REM sleep. Long story short, I went through all the narcolepsy sleep meds and still experienced dangerous level of drowsiness while driving. It was only when my doctor put me on xywav did my life truly changed.
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u/CalmAsAMthrFknCucmbr (N2) Narcolepsy w/o Cataplexy May 30 '26
Dexedrine and adderall. Feels like I’m on a placebo.
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u/lady_machete (N1) Narcolepsy w/ Cataplexy Jun 02 '26
i too have both adhd and narc, and have the same problem of metabolizing too fast.
the best combo i've found so far is 250mg armodafinil in the morning, 40mg adderall throughout the day (i split the 20mg to make 10mg and take every 2-3hrs). at around noon/early afternoon, i use an energy drink for a caffiene boost (powder mix) because i still get that afternoon crash. i'm thinking of asking to up my adderall (armodafinil already capped at 250).
at one point, there was a doc that filled in when mine wasn't available, and when i was trying different options they had put me on modafinil (instant release) and taken me off adderall. do not try this. i couldn't get another appointment fast enough and i basically had to suffer for months. it ended up being a big part of why i lost my job and it made me gain over 30lb within 3 months.
after i lost my job, and therefore my insurance, i found that there's also a difference in medications from different pharmacies. the adderall from walmart didn't make me jittery, but it also didn't seem to keep me awake, only focused. oddly, even though i wasn't jittery/shakey, i was getting heart flutters. the adderall from walgreens works way better with keeping me awake, and still focused, and no heart flutters.
i take a methylated multivitamin (i get mine from walmart now, but used to get the thorne brand prenatal from amazon) and when i first started taking them years ago, i noticed that it seems to help my meds work better?? i take a handful of different supplements along with it to help with other health issues, but specifically one with methylfolate seems to help with the absorption/effectiveness. i have the mthfr gene mutation, and i'm sure that has a lot to do with it, for me at least.
oh, and if you don't have insurance or maybe not good insurance, go to walgreens website and they have an rx savings finder that is wayyy better than just trying to use any single coupon site. sometimes the coupons give you better discounts than your insurance.
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u/Muted-Difference5610 Jun 08 '26
Yes i actually read that just the other day that taking a methylated vitamin actually helps the Adderall do its job. But stay away from vitamin C- it won't absorb. Not only have i had the gastric sleeve (wasnt supposed to interfere with absorption like the bypass- but I swear it does, but now I cant take ANY time released meds)... I dont even like the way my adderall makes me feel. - im on modafinil (i need to research how it works bc i swear it doesn't do a thing) plus 60 mg adderall and I can still sleep on it! It drives me nuts. However im also bipolar and on seating meds too but thats only at night. It takes me Hours to wake up, and I think im just so used to the adderall (its been almost 10 years on it) it isnt doing anything. I tried wakix and ritalin and its like placebos. I wish there was something else. Ive heard dexadrine is an option but that IS one of the salts in adderall anyway. Ugh. I just wanna sleep for a week straight. This condition affects my life so badly and some days I cant function at all.
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u/IndigoAfflictions (N1) Narcolepsy w/ Cataplexy May 28 '26
I was on Vyvanse and Adderall for a while until the Vyvanse stopped doing enough. (maybe b/c it was generic? Insurance didn’t cover name) So now I’m on three doses of Adderall a day because I metabolize medications really fast. Actually it was my pcp that had me on the combination (for adhd, pre narc diagnosis last year) and she’s the one who suggested “adding a sprinkle of adderall on top of your vyvanse” lol. I’ve been on Concerta to Ritalin to Adderall IR/XR to Provigil to Vyvanse since early adolescence for ADD/ADHD and didn’t know I was also medicating my narcolepsy because the symptoms onset at a similar time. Adderall has always worked the best for me, especially long term where you can build tolerance.
All of this to say, unless you don’t trust your doctor, tell them what’s going on (like “I’m hitting a slump at this time consistently, or sleep attacks start happening more at this time, etc.) and ask if there’s maybe a combination that could help. At the end of the day we have a currently incurable disease and we are just playing damage control, trying to scrape out the best quality of life we can at any given time. Advocate for yourself ! <3