ADHD: The Reality of Life on Elvanse

Here’s what it’s really like.

1. The First Day Feels Like Magic (Sometimes)

Many people describe their first day on Elvanse as a “lightbulb moment.” Suddenly, you can focus on a task for more than ten minutes without getting up to do something else. You can finish a cup of tea before it goes cold. The mental chatter that constantly interrupts you slows down, and you find yourself able to listen in conversations without zoning out.

It can feel like you’ve finally been given the tool everyone else was born with.

But not everyone has this dramatic moment. For some, it’s subtle—a slight ability to organise your thoughts, a calmer brain, or a gentle push toward productivity. Others may feel nothing at all on the first day, leading to frustration. 

My own journey started with Concerta, another stimulant based medication also known as Ritalin, however despite a strong start it ended causing me to be like a fireball of crippling anxiety... and anger.

My prescriber changed me over to Elvanse and after a few tweeks with my dosage, I am blessed to experience a lot of the benefits from the medication... yet, I still have concerns it comes at a price.

2. The Physical Side Effects Are Real

Elvanse is a stimulant, and your body knows it. Common realities include:

• Dry mouth (hello, constant water bottle)
• Loss of appetite (you might forget to eat, which feels strange if you’re used to food being your go-to comfort)
• Higher heart rate
• Jaw clenching or teeth grinding
• Difficulty sleeping if taken too late in the day

These side effects often settle down after a few weeks, but not always. Managing your hydration, nutrition, and sleep routine becomes a non-negotiable part of your day.

I have lost over 30lbs in the past year, mainly due to the fact I don't get as hungry or need as much food, however I still have quite the sweet tooth! I was always an emotional eater, but now when it happens I recognise it for what it is - which is progress. 

I do struggle massively with sleep. This is because I am so focused on things I find it really hard to switch off. For me there is never enough hours in a day. 

My biggest concern is my heart health whilst taking Elvanse. My heart rate has always been fast, but at the start of my treatment I had some scary moments where my heart was racing and it felt like I was about to die! It does seem to have settled, and I think removing my Apple Watch and refusing to fixate on it has helped. Along with quitting caffeine. Worryingly it has increased my blood pressure, so for me, I need to make some lifestyle changes to counteract this. 

Oh and the dry mouth... wow. 

3. It Doesn’t “Fix” Everything

Many people expect Elvanse to transform them into a super-productive, hyper-focused machine. The truth is, while Elvanse can help you access focus, it doesn’t tell you what to focus on or how to manage your time effectively.

If your environment is chaotic, or you don’t have structure in place, you may find yourself hyper-focusing on the wrong things, like organising and colour coding your files, instead of doing any actual work.

ADHD medication is a tool, not a cure. Therapy, routines, and self-compassion are still needed alongside it. 

I still haven't quite figured out my routine, and despite the fact I know I need therapy it's not been a priority in my busy life. What I have mastered though is self-compassion - I refuse to beat myself up over how my brain works. 

4. Emotional Blunting vs Emotional Regulation

Some people find Elvanse helps them feel calmer, less impulsive, and better able to manage emotional swings. Others notice a flattening of emotions, where they feel less excitement, joy, or motivation, even if they can concentrate better. 

This can be subtle but unsettling, and it’s worth tracking how your emotions shift on medication to discuss with your prescriber if needed.

I've heard many people say they hate the feeling that they have lost their personalities whilst being medicated, and this has been a huge factor when quitting the medication. 

In my case, I actually prefer myself on Elvanse. I have more confidence and volume level of rejection sensitivity is now like a muffled murmur in the background. I don't know if it's also me embracing a touch of "Hagatude" but I also feel like I no longer tolerate the bullshit I once did, and will rock the boat if I need to. 

5. You May Grieve the Time You Lost

When Elvanse allows you to see what your brain can do, it’s common to feel a wave of sadness or grief about the years spent struggling without knowing why. You might wonder how school or your career might have been different, or how your relationships could have been less strained.

This is a normal part of the journey and often part of ADHD diagnosis and treatment, not just the medication.

I try to warn every person I meet who is embarking on  seeking a diagnosis that they need to prepare for the grief that comes with it.

It's personal to all of us, and I think the older you are when you find out, the harder it can be to navigate those "what if?" reflections on the past. 

I think this is probably one of the biggest reasons therapy should come with a diagnosis! 

6. It’s About Finding Your Dose and Routine

Elvanse has a long-acting effect, but how it feels for you will depend on:

• Your dose
• Whether you take it before or after breakfast
• Your caffeine intake
• How well you sleep
• Your hormones

Some days it will work well, other days you might feel flat, overstimulated, or disconnected. This is normal, and it can take weeks (or even months) of fine-tuning with your prescriber to find your sweet spot.

As a woman I can say that our hormones play a huge part in how well the medication works. If there is a drop in my estrogen, I feel exhausted and the impact of Elvanse seems pathetic and weak.

Getting the sweet spot in dosing can be hard. I went up to 70mg at one point only to find it make me manic. I was like a hamster on a wheel sprinting uncontrollably, and saying some weird out of character stuff. However, this was also at the time I was experiencing the loss of my Grandma and that certainly didn't help. 

50mg is my happy dose. With 10mg of Amfexa on the days I need a boost! 

7. You Still Need to Do The Work

Medication helps you access focus, but it won’t plan your day, clean your kitchen, or send your emails. You still need to learn systems and routines that work for your ADHD brain, like body-doubling, using timers, or writing one task on a sticky note at a time.

This is where ADHD coaching, body doubling for the hard tasks, or using a productivity app can be the key to success. 

I still have times I get "stuck" I can't seem to do a particular task and I can put it off because it feels too overwhelming.

The thing to remember is that... 

ADHD is a explanation NOT and excuse.

In reality nobody is coming to save you and it's your responsibility to find ways to manage rather than succumb - just remember to give yourself the time and self compassion you need as well, then just get shit done as best as you can! 

8. It Can Change Your Life

Despite its limitations, for many, Elvanse is a game-changer. It can help you keep track of your keys, manage your projects, listen to your children, and complete your creative ideas. It can help you feel like your brain is finally working with you rather than against you.

I take my Elvanse in the knowledge it makes me better at handling my life. I like the energy boost and the confidence and the fact most of the time I feel happier as my brain clings to the dopamine hits for much longer. 

It has completely changed my life and how I navigate the challenges that previously held me back. 

Final Thoughts

Taking Elvanse for ADHD is rarely a “miracle cure,” but it can be a vital tool in building the life you want. It’s a journey of learning what works for your unique brain while managing the expectations you and others may have about what medication can and can’t do.

If you’re just starting out, keep a journal of how you feel, stay connected with your prescriber until you find the sweet spot, and remember: you’re not behind, you’re not broken, and you deserve the support that helps you thrive. 

You've got this. 

Fergs 🖤