60 mg of vyvanse

Contents

Vyvanse

CLINICAL PHARMACOLOGY

Mechanism Of Action

Lisdexamfetamine is a prodrug of dextroamphetamine. Amphetamines are non-catecholamine sympathomimetic amines with CNS stimulant activity. The exact mode of therapeutic action in ADHD and BED is not known.

Pharmacodynamics

Amphetamines block the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase the release of these monoamines into the extraneuronal space. The parent drug, lisdexamfetamine, does not bind to the sites responsible for the reuptake of norepinephrine and dopamine in vitro.

Pharmacokinetics

Pharmacokinetic studies after oral administration of lisdexamfetamine dimesylate have been conducted in healthy adult (capsule and chewable tablet formulations) and pediatric (6 to 12 years) patients with ADHD (capsule formulation). After single dose administration of lisdexamfetamine dimesylate, pharmacokinetics of dextroamphetamine was found to be linear between 30 mg and 70 mg in a pediatric study, and between 50 mg and 250 mg in an adult study. Dextroamphetamine pharmacokinetic parameters following administration of lisdexamfetamine dimesylate in adults exhibited low inter-subject (<25%) and intra-subject (<8%) variability. There is no accumulation of lisdexamfetamine and dextroamphetamine at steady state in healthy adults.

Safety and efficacy have not been studied above the maximum recommended dose of 70 mg.

Absorption

Capsule Formulation

Following single-dose oral administration of VYVANSE capsule (30 mg, 50 mg, or 70 mg) in patients ages 6 to 12 years with ADHD under fasted conditions, Tmax of lisdexamfetamine and dextroamphetamine was reached at approximately 1 hour and 3.5 hour post dose, respectively. Weight/Dose normalized AUC and Cmax values were the same in pediatric patients ages 6 to 12 years as the adults following single doses of 30 mg to 70 mg VYVANSE capsule.

Food Effect On Capsule Formulation

Neither food (a high fat meal or yogurt) nor orange juice affects the observed AUC and Cmax of dextroamphetamine in healthy adults after single-dose oral administration of 70 mg of VYVANSE capsules. Food prolongs Tmax by approximately 1 hour (from 3.8 hour at fasted state to 4.7 hour after a high fat meal or to 4.2 hour with yogurt). After an 8-hour fast, the AUC for dextroamphetamine following oral administration of lisdexamfetamine dimesylate in solution and as intact capsules were equivalent.

Chewable Tablet Formulation

After a single dose administration of 60 mg VYVANSE chewable tablet in healthy subjects under fasted conditions, Tmax of lisdexamfetamine and dextroamphetamine was reached at approximately 1 hour and 4.4 hour post dose, respectively. Compared to 60 mg VYVANSE capsule, exposure (Cmax and AUC) to lisdexamfetamine was about 15% lower. The exposure (Cmax and AUCinf) of dextroamphetamine is similar between VYVANSE chewable tablet and VYVANSE capsule.

Food Effect on Tablet Formulation

Administration of 60 mg VYVANSE chewable tablet with food (a high-fat meal) decreases the exposure (Cmax and AUCinf) of dextroamphetamine by about 5% to 7%, and prolongs mean Tmax by approximately 1 hour (from 3.9 hrs at fasted state to 4.9 hours).

Elimination

Plasma concentrations of unconverted lisdexamfetamine are low and transient, generally becoming non-quantifiable by 8 hours after administration. The plasma elimination half-life of lisdexamfetamine typically averaged less than one hour in studies of lisdexamfetamine dimesylate in volunteers. The mean plasma elimination half-life of dextroamphetamine was about 12 hours after oral administration of lisdexamfetamine dimesylate.

Metabolism

Lisdexamfetamine is converted to dextroamphetamine and l-lysine primarily in blood due to the hydrolytic activity of red blood cells after oral administration of lisdexamfetamine dimesylate. In vitro data demonstrated that red blood cells have a high capacity for metabolism of lisdexamfetamine; substantial hydrolysis occurred even at low hematocrit levels (33% of normal). Lisdexamfetamine is not metabolized by cytochrome P450 enzymes.

Excretion

Following oral administration of a 70 mg dose of radiolabeled lisdexamfetamine dimesylate to 6 healthy subjects, approximately 96% of the oral dose radioactivity was recovered in the urine and only 0.3% recovered in the feces over a period of 120 hours. Of the radioactivity recovered in the urine, 42% of the dose was related to amphetamine, 25% to hippuric acid, and 2% to intact lisdexamfetamine.

Specific Populations

Exposures of dextroamphetamine in specific populations are summarized in Figure 1.

Figure 1: Specific Populations*:


*Figure 1 shows the geometric mean ratios and the 90% confidence limits for Cmax and AUC of d-amphetamine. Comparison for gender uses males as the reference. Comparison for age uses 55-64 years as the reference.

Drug Interaction Studies

Effects of other drugs on the exposures of dextroamphetamine are summarized in Figure 2.

Figure 2: Effect of Other Drugs on VYVANSE:


The effects of VYVANSE on the exposures of other drugs are summarized in Figure 3.

Figure 3: Effect of VYVANSE on Other Drugs:


Animal Toxicology And/Or Pharmacology

Acute administration of high doses of amphetamine (d-or d,l-) has been shown to produce long-lasting neurotoxic effects, including irreversible nerve fiber damage, in rodents. The significance of these findings to humans is unknown.

Clinical Studies

Efficacy of VYVANSE in the treatment of ADHD has been established in the following trials:

  • Three short-term trials in children (6 to 12 years, Studies 1, 2, 3)
  • One short-term trial in adolescents (13 to 17 years, Study 4)
  • One short-term trial in children and adolescents (6 to 17 years, Study 5)
  • Two short-term trials in adults (18 to 55 years, Studies 7, 8)
  • Two randomized withdrawal trials in children and adolescents (6 to 17 years, Study 6), and adults (18 to 55 years, Study 9)

Efficacy of VYVANSE in the treatment of moderate to severe BED in adults has been established in the following trials:

  • One randomized trial in adults (18 to 55 years, Study 10)
  • Two short-term trials in adults (18 to 55 years, Studies 11 and 12)
  • One randomized withdrawal study in adults (18 to 55 years, Study 13)

Attention Deficit Hyperactivity Disorder (ADHD)

Patients Ages 6 To 12 Years Old With ADHD

A double-blind, randomized, placebo-controlled, parallel-group study (Study 1) was conducted in children ages 6 to 12 years (N=290) who met DSM-IV criteria for ADHD (either the combined type or the hyperactive-impulsive type). Patients were randomized to receive final doses of 30 mg, 50 mg, or 70 mg of VYVANSE or placebo once daily in the morning for a total of four weeks of treatment. All patients receiving VYVANSE were initiated on 30 mg for the first week of treatment. Patients assigned to the 50 mg and 70 mg dose groups were titrated by 20 mg per week until they achieved their assigned dose. The primary efficacy outcome was change in Total Score from baseline to endpoint in investigator ratings on the ADHD Rating Scale (ADHD-RS), an 18-item questionnaire with a score range of 0-54 points that measures the core symptoms of ADHD which includes both hyperactive/impulsive and inattentive subscales. Endpoint was defined as the last post-randomization treatment week (i.e. Weeks 1 through 4) for which a valid score was obtained. All VYVANSE dose groups were superior to placebo in the primary efficacy outcome. Mean effects at all doses were similar; however, the highest dose (70 mg/day) was numerically superior to both lower doses (Study 1 in Table 7). The effects were maintained throughout the day based on parent ratings (Conners’ Parent Rating Scale) in the morning (approximately 10 am), afternoon (approximately 2 pm), and early evening (approximately 6 pm).

A double-blind, placebo-controlled, randomized, crossover design, analog classroom study (Study 2) was conducted in children ages 6 to 12 years (N=52) who met DSM-IV criteria for ADHD (either the combined type or the hyperactive-impulsive type). Following a 3-week open-label dose optimization with Adderall XR®, patients were randomly assigned to continue their optimized dose of Adderall XR (10 mg, 20 mg, or 30 mg), VYVANSE (30 mg, 50 mg, or 70 mg), or placebo once daily in the morning for 1 week each treatment. Efficacy assessments were conducted at 1, 2, 3, 4.5, 6, 8, 10, and 12 hours post-dose using the Swanson, Kotkin, Agler, M.Flynn, and Pelham Deportment scores (SKAMP-DS), a 4-item subscale of the SKAMP with scores ranging from 0 to 24 points that measures deportment problems leading to classroom disruptions. A significant difference in patient behavior, based upon the average of investigator ratings on the SKAMP-DS across the 8 assessments were observed between patients when they received VYVANSE compared to patients when they received placebo (Study 2 in Table 7). The drug effect reached statistical significance from hours 2 to 12 post-dose, but was not significant at 1 hour.

A second double-blind, placebo-controlled, randomized, crossover design, analog classroom study (Study 3) was conducted in children ages 6 to 12 years (N=129) who met DSM-IV criteria for ADHD (either the combined type or the hyperactive-impulsive type). Following a 4-week open-label dose optimization with VYVANSE (30 mg, 50 mg, 70 mg), patients were randomly assigned to continue their optimized dose of VYVANSE or placebo once daily in the morning for 1 week each treatment. A significant difference in patient behavior, based upon the average of investigator ratings on the SKAMP-Deportment scores across all 7 assessments conducted at 1.5, 2.5, 5.0, 7.5, 10.0, 12.0, and 13.0 hours post-dose, were observed between patients when they received VYVANSE compared to patients when they received placebo (Study 3 in Table 7, Figure 4).

Patients Ages 13 To 17 Years Old With ADHD

A double-blind, randomized, placebo-controlled, parallel-group study (Study 4) was conducted in adolescents ages 13 to 17 years (N=314) who met DSM-IV criteria for ADHD. In this study, patients were randomized in a 1:1:1:1 ratio to a daily morning dose of VYVANSE (30 mg/day, 50 mg/day or 70 mg/day) or placebo for a total of four weeks of treatment. All patients receiving VYVANSE were initiated on 30 mg for the first week of treatment. Patients assigned to the 50 mg and 70 mg dose groups were titrated by 20 mg per week until they achieved their assigned dose. The primary efficacy outcome was change in Total Score from baseline to endpoint in investigator ratings on the ADHD Rating Scale (ADHD-RS). Endpoint was defined as the last post-randomization treatment week (i.e. Weeks 1 through 4) for which a valid score was obtained. All VYVANSE dose groups were superior to placebo in the primary efficacy outcome (Study 4 in Table 7).

Patients Ages 6 To 17 Years Old: Short-Term Treatment In ADHD

A double-blind, randomized, placebo-and active-controlled parallel-group, dose-optimization study (Study 5) was conducted in children and adolescents ages 6 to 17 years (n=336) who met DSM-IV criteria for ADHD. In this eight-week study, patients were randomized to a daily morning dose of VYVANSE (30, 50 or 70mg/day), an active control, or placebo (1:1:1). The study consisted of a Screening and Washout Period (up to 42 days), a 7-week Double-blind Evaluation Period (consisting of a 4-week Dose-Optimization Period followed by a 3-week Dose-Maintenance Period), and a 1-week Washout and Follow-up Period. During the Dose Optimization Period, subjects were titrated until an optimal dose, based on tolerability and investigator’s judgment, was reached. VYVANSE showed significantly greater efficacy than placebo. The placebo-adjusted mean reduction from baseline in the ADHD-RS-IV total score was 18.6. Subjects on VYVANSE also showed greater improvement on the Clinical Global Impression-Improvement (CGI-I) rating scale compared to subjects on placebo (Study 5 in Table 7).

Patients Ages 6 to 17 Years Old: Maintenance Treatment in ADHD Maintenance of Efficacy Study (Study 6) -A double-blind, placebo-controlled, randomized withdrawal study was conducted in children and adolescents ages 6 to 17 (N=276) who met the diagnosis of ADHD (DSM-IV criteria). A total of 276 patients were enrolled into the study, 236 patients participated in Study 5 and 40 subjects directly enrolled. Subjects were treated with open-label VYVANSE for at least 26 weeks prior to being assessed for entry into the randomized withdrawal period. Eligible patients had to demonstrate treatment response as defined by CGI-S <3 and Total Score on the ADHD-RS ≤22. Patients that maintained treatment response for 2 weeks at the end of the open label treatment period were eligible to be randomized to ongoing treatment with the same dose of VYVANSE (N=78) or switched to placebo (N=79) during the double-blind phase. Patients were observed for relapse (treatment failure) during the 6 week double blind phase. A significantly lower proportion of treatment failures occurred among VYVANSE subjects (15.8%) compared to placebo (67.5%) at endpoint of the randomized withdrawal period. The endpoint measurement was defined as the last post-randomization treatment week at which a valid ADHD-RS Total Score and CGI-S were observed. Treatment failure was defined as a ≥50% increase (worsening) in the ADHD-RS Total Score and a ≥2-point increase in the CGI-S score compared to scores at entry into the double-blind randomized withdrawal phase. Subjects who withdrew from the randomized withdrawal period and who did not provide efficacy data at their last on-treatment visit were classified as treatment failures (Study 6, Figure 5).

Adults:Short-Term Treatment In ADHD

A double-blind, randomized, placebo-controlled, parallel-group study (Study 7) was conducted in adults ages 18 to 55 (N=420) who met DSM-IV criteria for ADHD. In this study, patients were randomized to receive final doses of 30 mg, 50 mg, or 70 mg of VYVANSE or placebo for a total of four weeks of treatment. All patients receiving VYVANSE were initiated on 30 mg for the first week of treatment. Patients assigned to the 50 mg and 70 mg dose groups were titrated by 20 mg per week until they achieved their assigned dose. The primary efficacy outcome was change in Total Score from baseline to endpoint in investigator ratings on the ADHD Rating Scale (ADHD-RS). Endpoint was defined as the last post-randomization treatment week (i.e. Weeks 1 through 4) for which a valid score was obtained. All VYVANSE dose groups were superior to placebo in the primary efficacy outcome (Study 7 in Table 7). The second study was a multi-center, randomized, double-blind, placebo-controlled, cross-over, modified analog classroom study (Study 8) of VYVANSE to simulate a workplace environment in 142 adults ages 18 to 55 who met DSM-IV-TR criteria for ADHD. There was a 4-week open-label, dose optimization phase with VYVANSE (30 mg/day, 50 mg/day, or 70 mg/day in the morning). Patients were then randomized to one of two treatment sequences: 1) VYVANSE (optimized dose) followed by placebo, each for one week, or 2) placebo followed by VYVANSE, each for one week. Efficacy assessments occurred at the end of each week, using the Permanent Product Measure of Performance (PERMP), a skill-adjusted math test that measures attention in ADHD. PERMP total score results from the sum of the number of math problems attempted plus the number of math problems answered correctly. VYVANSE treatment, compared to placebo, resulted in a statistically significant improvement in attention across all post-dose time points, as measured by average PERMP total scores over the course of one assessment day, as well as at each time point measured. The PERMP assessments were administered at pre-dose (-0.5 hours) and at 2, 4, 8, 10, 12, and 14 hours post-dose (Study 8 in Table 7, Figure 6).

Adults:Maintenance Treatment In ADHD

A double-blind, placebo-controlled, randomized withdrawal design study (Study 9) was conducted in adults ages 18 to 55 (N=123) who had a documented diagnosis of ADHD or met DSM-IV criteria for ADHD. At study entry, patients must have had documentation of treatment with VYVANSE for a minimum of 6 months and had to demonstrate treatment response as defined by Clinical Global Impression Severity (CGI-S) ≤3 and Total Score on the ADHD-RS <22. ADHD-RS Total Score is a measure of core symptoms of ADHD. The CGI-S score assesses the clinician’s impression of the patient’s current illness state and ranges from 1 (not at all ill) to 7 (extremely ill). Patients that maintained treatment response at week 3 of the open label treatment phase (N=116) were eligible to be randomized to ongoing treatment with the same dose of VYVANSE (N=56) or switched to placebo (N=60) during the double-blind phase. Patients were observed for relapse (treatment failure) during the 6-week double-blind phase. The efficacy endpoint was the proportion of patients with treatment failure during the double-blind phase. Treatment failure was defined as a ≥50% increase (worsening) in the ADHD-RS Total Score and ≥2-point increase in the CGI-S score compared to scores at entry into the double-blind phase. Maintenance of efficacy for patients treated with VYVANSE was demonstrated by the significantly lower proportion of patients with treatment failure (9%) compared to patients receiving placebo (75%) at endpoint during the double-blind phase (Study 9, Figure 7).

Table 7: Summary of Primary Efficacy Results from Short-term Studies of VYVANSE in Children, Adolescents, and Adults with ADHD

Figure 4: LS Mean SKAMP Deportment Subscale Score by Treatment and Time-point for Children Ages 6 to 12 with ADHD after 1 Week of Double Blind Treatment (Study 3)


Higher score on the SKAMP-Deportment scale indicates more severe symptoms

Figure 5: Kaplan-Meier Estimated Proportion of Patients with Treatment Failure for Children and Adolescent Ages 6-17 (Study 6)


Figure 6: LS Mean (SE) PERMP Total Score by Treatment and Time-point for Adults Ages 18 to 55 with ADHD after 1 Week of Double Blind Treatment (Study 8)


Higher score on the PERMP scale indicates less severe symptoms.

Figure 7: Kaplan-Meier Estimated Proportion of Subjects with Relapse in Adults with ADHD (Study 9)


Binge Eating Disorder (BED)

A phase 2 study evaluated the efficacy of VYVANSE 30, 50 and 70 mg/day compared to placebo in reducing the number of binge days/week in adults with at least moderate to severe BED. This randomized, double-blind, parallel-group, placebo-controlled, forced-dose titration study (Study 10) consisted of an 11-week double-blind treatment period (3 weeks of forced-dose titration followed by 8 weeks of dose maintenance). VYVANSE 30 mg/day was not statistically different from placebo on the primary endpoint. The 50 and 70 mg/day doses were statistically superior to placebo on the primary endpoint. The efficacy of VYVANSE in the treatment of BED was demonstrated in two 12-week randomized, double-blind, multi-center, parallel-group, placebo-controlled, dose-optimization studies (Study 11 and Study 12) in adults aged 18-55 years (Study 11: N=374, Study 12: N=350) with moderate to severe BED. A diagnosis of BED was confirmed using DSM-IV criteria for BED. Severity of BED was determined based on having at least 3 binge days per week for 2 weeks prior to the baseline visit and on having a Clinical Global Impression Severity (CGI-S) score of ≥4 at the baseline visit. For both studies, a binge day was defined as a day with at least 1 binge episode, as determined from the subject’s daily binge diary.

Both 12-week studies consisted of a 4-week dose-optimization period and an 8-week dose-maintenance period. During dose-optimization, subjects assigned to VYVANSE began treatment at the titration dose of 30 mg/day and, after 1 week of treatment, were subsequently titrated to 50mg/day. Additional increases to 70 mg/day were made as tolerated and clinically indicated. Following the dose-optimization period, subjects continued on their optimized dose for the duration of the dose-maintenance period.

The primary efficacy outcome for the two studies was defined as the change from baseline at Week 12 in the number of binge days per week. Baseline is defined as the weekly average of the number of binge days per week for the 14 days prior to the baseline visit. Subjects from both studies on VYVANSE had a statistically significantly greater reduction from baseline in mean number of binge days per week at Week 12. In addition, subjects on VYVANSE showed greater improvement as compared to placebo across key secondary outcomes with higher proportion of subjects rated improved on the CGI-I rating scale, higher proportion of subjects with 4-week binge cessation, and greater reduction in the Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating (Y-BOCS-BE) total score.

Table 8: Summary of Primary Efficacy Results in BED

A double-blind, placebo controlled, randomized withdrawal design study (Study 13) was conducted to evaluate maintenance of efficacy based on time to relapse between VYVANSE and placebo in adults aged 18 to 55 (N=267) with moderate to severe BED. In this longer-term study patients who had responded to VYVANSE in the preceding 12-week open-label treatment phase were randomized to continuation of VYVANSE or placebo for up to 26 weeks of observation for relapse. Response in the open-label phase was defined as 1 or fewer binge days each week for four consecutive weeks prior to the last visit at the end of the 12-week open-label phase and a CGI-S score of 2 or less at the same visit. Relapse during the double-blind phase was defined as having 2 or more binge days each week for two consecutive weeks (14 days) prior to any visit and having an increase in CGI-S score of 2 or more points compared to the randomized-withdrawal baseline. Maintenance of efficacy for patients who had an initial response during the open-label period and then continued on VYVANSE during the 26-week double-blind randomized-withdrawal phase was demonstrated with VYVANSE being superior over placebo as measured by time to relapse.

Figure 8: Kaplan-Meier Estimated Proportion of Subjects with Relapse in Adults with BED (Study 13)


Examination of population subgroups based on age (there were no patients over 65), gender, and race did not reveal any clear evidence of differential responsiveness in the treatment of BED.

What is Vyvanse (lisdexamfetamine)?

Vyvanse is a brand name prescription drug used to treat attention deficit hyperactivity disorder (ADHD) in children and adults, and binge eating disorder in adults.

How does Vyvanse work?

Vyvanse is a stimulant that affects the parts of the brain and central nervous system that control hyperactivity and impulses.

When did the U.S. Food and Drug Administration approve Vyvanse?

In 2007, Vyvanse was approved as a once-a-day medication for the treatment of ADHD for adults. In 2013, it was approved for use among children ages 6 to 17 for the treatment of ADHD. The medication was approved for the treatment of binge eating disorder in adults in 2015.

Is there a generic version of Vyvanse available?

Currently there is no generic version of Vyvanse available for purchase in the United States.

What is the difference between Vyvanse and Ritalin?

Both drugs are stimulants used to treat ADHD. The major difference is that Vyvanse is a once-a-day drug which is typically taken in the morning and has long-lasting effects, whereas Ritalin comes in both short-acting and long-acting form.

Both drugs are classified as controlled substances, meaning they have the potential to be abused. Because of the way the Vyvanse breaks down in the body, it may have a slightly less risk of being abused than Ritalin. However, if you have a history of substance use problems, you should talk to your doctor before taking either medication.

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Can children take Vyvanse?

Children over the age of 6 may be prescribed Vyvanse for ADHD. They should take the medication only once per day and in the exact amount prescribed by their doctor. It’s also important to tell your child’s doctor about other medication complications or past substance use history.

How do you initiate Vyvanse therapy?

Talk to your doctor about whether you are a good fit for the medication. Typically instructions are to take the drug once in the morning and in the exact amount prescribed by your doctor. There are seven different dosage strengths for which the medication may be prescribed. The medication can be swallowed whole and taken with or without food.

Are there potential interaction issues for people taking Vyvanse and any other drugs?

Do not take Vyvanse if you have taken an MAO inhibitor in the past two weeks, as a dangerous interaction effect could occur. There are also hundreds of drugs which are known to interact with Vyvanse in major, moderate, or mild ways, so let your doctor know what other medications you are taking before you begin Vyvanse therapy.

What is the typical dose that would be prescribed to someone taking Vyvanse?

The initial dose is typically 30 mg every morning for treatment of ADHD or binge eating disorder. The recommended dosage typically can be anywhere from 30 mg to 70 mg per day for ADHD and 50 mg to 70 mg per day for binge eating disorder.

How long does it usually take for Vyvanse to work?

Vyvanse was shown to start working within 1.5 hours after taking the medication in a clinical trial of children ages 6 to 12 with ADHD. In a study of adults diagnosed with ADHD, the drug was shown to start working within 2 hours.

What do I do if I miss a dose of Vyvanse?

You can take the dose when you remember, but taking the medication in the evening may cause sleep disturbances. Never take extra doses of the medication to make up for missed doses.

What are Vyvanse’s side effects?

These are the most common side effects reported by people who take Vyvanse:

  • loss of appetite
  • dry mouth
  • diarrhea
  • dizziness
  • insomnia
  • stomach pain
  • nausea or vomiting
  • weight loss.

Long-term use of the medication can also slow the growth of children, so it’s important to report slow growth or lack of weight gain to your child’s doctor. If you experience side effects, talk to your doctor. You can also report them to the FDA at 1-800-FDA-1088 or online.

Are there any psychiatric side effects that come from taking Vyvanse?

People who take Vyvanse may experience anxiety and irritability.

Is it safe for a woman who is trying to become pregnant, is pregnant or nursing to take Vyvanse?

If taken while pregnant, Vyvanse can cause low birth weight, premature birth, and withdrawal symptoms in infants. The drug can also be transferred via breast milk. Therefore, if you are pregnant, planning to become pregnant, or are nursing talk to your doctor before you take Vyvanse.

Can symptoms occur if Vyvanse is discontinued?

The medication typically stays in your system for approximately 3 days after you discontinue use, so withdrawal symptoms may occur within one week of halting use. People may experience anxiety, trouble concentrating, mild depression, fatigue, irritability, headaches, lack of motivation, mood swings, and sleepiness.

If taken in overdose, is Vyvanse toxic?

An overdose of Vyvanse could be fatal, so seek immediately help or call the Poison Help Line at 1-800-222-1222 if you overdose. Overdose symptoms might include rapid breathing, hallucinations, irregular heartbeats, aggressiveness, restlessness, nausea or vomiting, diarrhea, stomach pain, fainting, muscle pain or twitches, panic, flu symptoms, dark urine, seizures, or coma.

Is Vyvanse habit-forming?

Vyvanse is a federally controlled substance and a drug of abuse and can be habit-forming. Because it is long-lasting, however, Vyvanse may be less habit-forming than other medications for ADHD. Make sure that you keep track of the medication and never take more than prescribed. It is illegal to give or sell the medication to others. Talk to your doctor if you have a past history of substance dependence before you begin Vyvanse therapy.

How much does Vyvanse cost?

A 30-day supply of 30 mg Vyvanse tablets costs approximately $270.

Are there any disadvantages to Vyvanse?

Some patients do not respond to Vyvanse as strongly as they do to other ADHD medications, such as Adderall. Also, there is currently no generic version of Vyvanse available, which makes it more expensive.

DISCLAIMER: The information herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. This article mentions drugs that were FDA-approved and available at the time of publication and may not include all possible drug interactions or all FDA warnings or alerts. The author of this page explicitly does not endorse this drug or any specific treatment method. If you have health questions or concerns about interactions, please check with your physician or go to the FDA site for a comprehensive list of warnings.

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Last Updated: Nov 25, 2018

SIDE EFFECTS

The following adverse reactions are discussed in greater detail in other sections of the labeling:

  • Known hypersensitivity to amphetamine products or other ingredients of VYVANSE
  • Hypertensive Crisis When Used Concomitantly with Monoamine Oxidase Inhibitors
  • Drug Dependence
  • Serious Cardiovascular Reactions
  • Blood Pressure and Heart Rate Increases
  • Psychiatric Adverse Reactions
  • Suppression of Growth
  • Peripheral Vasculopathy, including Raynaud’s phenomenon
  • Serotonin Syndrome

Clinical Trial Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Attention Deficit Hyperactivity Disorder

The safety data in this section is based on data from the 4-week parallel-group controlled clinical studies of VYVANSE in pediatric and adult patients with ADHD .

Adverse Reactions Associated with Discontinuation of Treatment in ADHD Clinical Trials

In the controlled trial in patients ages 6 to 12 years (Study 1), 8% (18/218) of VYVANSE-treated patients discontinued due to adverse reactions compared to 0% (0/72) of placebo-treated patients. The most frequently reported adverse reactions (1% or more and twice rate of placebo) were ECG voltage criteria for ventricular hypertrophy, tic, vomiting, psychomotor hyperactivity, insomnia, decreased appetite and rash . Less frequently reported adverse reactions (less than 1% or less than twice rate of placebo) included abdominal pain upper, dry mouth, weight decreased, dizziness, somnolence, logorrhea, chest pain, anger and hypertension.

In the controlled trial in patients ages 13 to 17 years (Study 4), 3% (7/233) of VYVANSE-treated patients discontinued due to adverse reactions compared to 1% (1/77) of placebo-treated patients. The most frequently reported adverse reactions (1% or more and twice rate of placebo) were decreased appetite (2/233; 1%) and insomnia (2/233; 1%). Less frequently reported adverse reactions (less than 1% or less than twice rate of placebo) included irritability, dermatillomania, mood swings, and dyspnea.

Adverse Reactions Occurring at an Incidence of ≥5% or More Among VYVANSE Treated Patients with ADHD in Clinical Trials

The most common adverse reactions (incidence ≥5% and at a rate at least twice placebo) reported in children, adolescents, and/or adults were anorexia, anxiety, decreased appetite, decreased weight, diarrhea, dizziness, dry mouth, irritability, insomnia, nausea, upper abdominal pain, and vomiting.

Adverse Reactions Occurring at an Incidence of 2% or More Among VYVANSE Treated Patients with ADHD in Clinical Trials

Adverse reactions reported in the controlled trials in pediatric patients ages 6 to 12 years (Study 1), adolescent patients ages 13 to 17 years (Study 4), and adult patients (Study 7) treated with VYVANSE or placebo are presented in Tables 1, 2, and 3 below.

Table 1: Adverse Reactions Reported by 2% or More of Children (Ages 6 to 12 Years) with ADHD Taking VYVANSE and at least Twice the Incidence in Patients Taking Placebo in a 4-Week Clinical Trial (Study 1)

Table 2: Adverse Reactions Reported by 2% or More of Adolescent (Ages 13 to 17 Years) Patients with ADHD Taking VYVANSE and at least Twice the Incidence in Patients Taking Placebo in a 4-Week Clinical Trial (Study 4)

Table 3: Adverse Reactions Reported by 2% or More of Adult Patients with ADHD Taking VYVANSE and at least Twice the Incidence in Patients Taking Placebo in a 4-Week Clinical Trial (Study 7)

In addition, in the adult population erectile dysfunction was observed in 2.6% of males on VYVANSE and 0% on placebo; decreased libido was observed in 1.4% of subjects on VYVANSE and 0% on placebo.

Weight Loss and Slowing Growth Rate in Pediatric Patients with ADHD

In a controlled trial of VYVANSE in children ages 6 to 12 years (Study 1), mean weight loss from baseline after 4 weeks of therapy was -0.9, -1.9, and -2.5 pounds, respectively, for patients receiving 30 mg, 50 mg, and 70 mg of VYVANSE, compared to a 1 pound weight gain for patients receiving placebo. Higher doses were associated with greater weight loss with 4 weeks of treatment. Careful follow-up for weight in children ages 6 to 12 years who received VYVANSE over 12 months suggests that consistently medicated children (i.e. treatment for 7 days per week throughout the year) have a slowing in growth rate, measured by body weight as demonstrated by an age-and sex-normalized mean change from baseline in percentile, of -13.4 over 1 year (average percentiles at baseline and 12 months were 60.9 and 47.2, respectively). In a 4-week controlled trial of VYVANSE in adolescents ages 13 to 17 years, mean weight loss from baseline to endpoint was -2.7, -4.3, and -4.8 lbs., respectively, for patients receiving 30 mg, 50 mg, and 70 mg of VYVANSE, compared to a 2.0 pound weight gain for patients receiving placebo.

Careful follow-up of weight and height in children ages 7 to 10 years who were randomized to either methylphenidate or non-medication treatment groups over 14 months, as well as in naturalistic subgroups of newly methylphenidate-treated and non-medication treated children over 36 months (to the ages of 10 to 13 years), suggests that consistently medicated children (i.e. treatment for 7 days per week throughout the year) have a temporary slowing in growth rate (on average, a total of about 2 cm less growth in height and 2.7 kg less growth in weight over 3 years), without evidence of growth rebound during this period of development. In a controlled trial of amphetamine (d-to l-enantiomer ratio of 3:1) in adolescents, mean weight change from baseline within the initial 4 weeks of therapy was -1.1 pounds and -2.8 pounds, respectively, for patients receiving 10 mg and 20 mg of amphetamine. Higher doses were associated with greater weight loss within the initial 4 weeks of treatment .

Weight Loss in Adults with ADHD

In the controlled adult trial (Study 7), mean weight loss after 4 weeks of therapy was 2.8 pounds, 3.1 pounds, and 4.3 pounds, for patients receiving final doses of 30 mg, 50 mg, and 70 mg of VYVANSE, respectively, compared to a mean weight gain of 0.5 pounds for patients receiving placebo.

Binge Eating Disorder

The safety data in this section is based on data from two 12 week parallel group, flexible-dose, placebo-controlled studies in adults with BED . Patients with cardiovascular risk factors other than obesity and smoking were excluded.

Adverse Reactions Associated with Discontinuation of Treatment in BED Clinical Trials

In controlled trials of patients ages 18 to 55 years, 5.1% (19/373) of VYVANSE-treated patients discontinued due to adverse reactions compared to 2.4% (9/372) of placebo-treated patients. No single adverse reaction led to discontinuation in 1% or more of VYVANSE-treated patients. Less commonly reported adverse reactions (less than 1% or less than twice rate of placebo) included increased heart rate, headache, abdominal pain upper, dyspnea, rash, insomnia, irritability, feeling jittery and anxiety.

The most common adverse reactions (incidence ≥5% and at a rate at least twice placebo) reported in adults were dry mouth, insomnia, decreased appetite, increased heart rate, constipation, feeling jittery, and anxiety.

Adverse reactions reported in the pooled controlled trials in adult patients (Study 11 and 12) treated with VYVANSE or placebo are presented in Table 4 below.

Table 4: Adverse Reactions Reported by 2% or More of Adult Patients with BED Taking VYVANSE and at least Twice the Incidence in Patients Taking Placebo in 12-Week Clinical Trials (Study 11 and 12)

Postmarketing Experience

The following adverse reactions have been identified during post approval use of VYVANSE. Because these reactions are reported voluntarily from a population of uncertain size, it is not possible to reliably estimate their frequency or establish a causal relationship to drug exposure. These events are as follows: cardiomyopathy, mydriasis, diplopia, difficulties with visual accommodation, blurred vision, eosinophilic hepatitis, anaphylactic reaction, hypersensitivity, dyskinesia, dysgeusia, tics, bruxism, depression, dermatillomania, alopecia, aggression, Stevens-Johnson Syndrome, chest pain, angioedema, urticaria, seizures, libido changes, frequent or prolonged erections, constipation, and rhabdomyolysis.

Read the entire FDA prescribing information for Vyvanse (Lisdexamfetamine Dimesylate)

Adderall vs. Vyvanse: What’s the Difference?

Adderall(amphetamine and dextroamphetamine) and Vyvanse (lisdexamfetamine) are central nervous system stimulant medications. They are both approved to treat ADHD (attention deficit hyperactivity disorder).

Vyvanse is not approved for use for children under the age of 6. Adderall is also approved to treat the sleep disorder narcolepsy, and Vyvanse is approved by the Food and Drug Administration to treat binge eating disorder in individuals over the age of 18.

Both drugs are classified as controlled substances by the United States Drug Enforcement Administration in the Schedule II category, indicating that they are at the highest level of control for drugs that can be obtained by people with a prescription from a physician. This means that the federal government considers both of these drugs to have a significant potential to produce physical dependence in people who use them and are high-risk potential drugs of abuse.

Comparison of the Two Drugs

Based on information from the books Attention Deficit Hyperactivity Disorder Handbook: A Physician’s Guide to ADHD and Pharmacovigilance in Psychiatry, a brief comparison follows.

  • Adderall was approved for use in 1996; Vyvanse was approved for use in 2007.
  • Adderall is listed as a psychostimulant; Vyvanse is also listed as a psychostimulant.
  • The approved uses for Adderall include the treatment of ADHD and narcolepsy; the approved uses for Vyvanse include to treat ADHD and binge eating disorder.
  • The active ingredients in Adderall are dextroamphetamine (about 75 percent of the drug) and levoamphetamine (about 25 percent of the drug); the active ingredient in Vyvanse is lisdexamfetamine.
  • Adderall comes in an immediate-release form and an extended-release form; Vyvanse comes in a capsule form that is an extended-release version.
  • The duration of action for the immediate-release version of Adderall is about 4–6 hours, whereas the extended-release version lasts about 12 hours. The duration of effects for Vyvanse is about 10–13 hours, though some studies report it is up to 14 hours.
  • Both drugs have a very similar side effect profile. However, Vyvanse is a prodrug, which is an inert substance that is metabolized in the body to become an active medication. This means that the side effects from Vyvanse are considered to be less harsh.
  • These drugs are considered to be potential drugs of abuse; however, because Vyvanse is a prodrug and takes longer to metabolize in the system than Adderall, it is considered to have a lower risk of abuse.
  • Adderall functions by inhibiting the reuptake of the excitatory neurotransmitters dopamine and norepinephrine, and releasing dopamine and norepinephrine from storage sites.
  • The lisdexamfetamine in Vyvanse is metabolized into dextroamphetamine and then functions by increasing the availability of dopamine and norepinephrine in the central nervous system.
  • The half-life of Adderall is about 11–13 hours; the half-life of the Vyvanse is about 10–12 hours.
  • Adderall can be obtained in a generic version that can be relatively inexpensive, but Vyvanse can only be obtained by its current brand name.

The drugs are both controlled substances, and as mentioned above, this means that they are believed to have a potential for abuse and the development of physical dependence. However, a prodrug like Vyvanse is inactive in the system until it is metabolized by enzymes in the body. Therefore, Vyvanse can only be taken orally, whereas Adderall can be ground up and snorted or mixed with water and injected. This means that the manufacturers of Vyvanse advertise it as being less likely to be abused. In addition, prodrugs like Vyvanse are believed to be absorbed much more efficiently and smoothly due to their biochemistry. When the drug wears off, it is believed to produce fewer negative effects (e.g., the crash that occurs from stimulants once a person stops using them).

The biggest differences between the two drugs are how they are metabolized by the body, how often a person needs to take them (especially in the case of the immediate-release version of Adderall versus Vyvanse), and their projected potential to be drugs of abuse.

Prescribing Considerations

The decision whether to prescribed Adderall or Vyvanse is made by a physician based on the physician’s knowledge of the patient, the side effect profile of the drug, and the specific symptoms the physician is attempting to address. Side effect profiles of drugs are often considered by physicians before making a choice on which medications are going to be prescribed to a patient. The side effect profiles of both Adderall and Vyvanse include the following:

  • Nausea, vomiting, stomach pain or stomach cramps, and/or diarrhea
  • Dizziness, dry mouth, and/or headache
  • A loss of appetite and weight loss
  • Difficulties with sleep
  • Irritability or anxiety (or both)
  • Increased heart rate and/or increased blood pressure
  • Shortness of breath
  • Hallucinations, suspiciousness (or paranoia), or mania

In rare cases, there is a potential risk for heart attack or stroke with any type of stimulant use. Physicians would consider the patient’s history and specific vulnerabilities, and based on the potential side effect profiles of each medication, decide which would be most appropriate. For instance, Vyvanse would be expected to have less intense side effects than Adderall in most cases. Therefore, a client who might be susceptible to problems with sleep, appetite loss, or anxiety might be more likely to be placed on Vyvanse than Adderall. Because Vyvanse is an extended-release version and has a slightly longer duration of medicinal effects, this could be a consideration for some physicians.

Both medications have different interactions with other types of medications and substances. Physicians typically review the list of medications the patient brings with them and then decides on the approach that would be less likely to produce a negative interaction with the current medication regime, or they may change some medications to allow for the prescription of the particular stimulant of choice.

Of course, the potential for abuse could also be a significant factor in the decision. For those who may be more prone to abuse stimulant medications, a physician may decide that Vyvanse is a better choice.

Finally, physicians often prescribe medications based on their own experience and knowledge. They may feel that they see better results with Vyvanse compared to Adderall or other medications. Very often, the chosen medication for treating a recently diagnosed condition in an individual boils down to a trial and error type of process. The physician prescribes the medication that they feel best fits the patient’s needs and then the patient provides feedback on how the medication is working and the side effects they are experiencing.

Based on the feedback from the patient, the dosage of the medication can be altered, or they may try a completely new medication. Very often, a physician may prescribe several different medications in several different doses until they are able to find the specific medication and dosage that works for the individual in question. Thus, there are numerous factors that physicians must consider when attempting to find the right medication for the specific patient.

What is the link between Vyvanse and hypersexuality?

Doctors may prescribe Vyvanse to treat people with attention deficit hyperactivity disorder (ADHD) and those with binge eating disorder (BED).

ADHD

Share on PinterestA person with ADHD may experience difficulty paying attention or sustaining conversations.

Some doctors prescribe Vyvanse to treat the symptoms of ADHD, which include:

  • difficulty paying attention
  • hyperactivity
  • acting without thinking

According to the National Institute of Mental Health, the warning signs of ADHD can include:

  • overlooking or missing details and making careless mistakes
  • problems sustaining attention while listening, having conversations, or reading
  • inability to listen to direct communication
  • not being able to follow instructions
  • losing focus or becoming easily sidetracked
  • problems organizing tasks and activities

A growing body of evidence suggests that ADHD also has an effect on sexual activity. In one study from 2006, researchers found that people who had ADHD from childhood tended to start having sex earlier and have more sexual partners and more casual sex than people without ADHD.

Binge eating disorder

Doctors may also prescribe Vyvanse to help treat BED. People with this condition typically have binge eating episodes that last about 2 hours and involve at least three of the following behaviors:

  • eating much more quickly than usual
  • eating to the point of feeling uncomfortably full
  • eating large amounts despite not feeling hungry
  • eating alone to hide feelings of embarrassment relating to eating
  • feeling disgusted, distressed, depressed, or guilty after the binge

Such binge eating tends to happen at least once a week for a minimum of 3 months. The person does not usually purge, or make themselves sick, afterward.

Females living with eating disorders are more likely to suffer from sexual dysfunction. A review of current research reported that women with anorexia, bulimia, or BED had fewer sexual partners and fewer sexual relationships than women without any of these conditions.

Eating disorders can cause sexual dysfunction and decreased libido. A person who has an eating disorder may also avoid sex because they feel anxious or self-conscious.

Concerta vs. Vyvanse for ADHD

Share on PinterestA doctor may prescribe Vyvanse or Concerta to treat ADHD.

People can take Concerta or Vyvanse for ADHD, but doctors can also prescribe Vyvanse for binge eating disorder.

As Concerta and Vyvanse are both stimulants, their effects are very similar. The most significant difference between them is that Vyvanse is a prodrug, which means that it is inactive until the body metabolizes it.

Both drugs are long-acting, with their effects lasting for about 12 hours, which can be helpful for people who do not wish to take medication several times a day.

Taking medication only once a day can be especially good for children, who may find it difficult to remember to take further doses.

Concerta

The generic drug name of Concerta is methylphenidate. Methylphenidate is also the drug that manufacturers use in Ritalin. The difference between Concerta and Ritalin is how long the medication lasts in the body.

Concerta uses an osmotic-controlled release oral delivery system (OROS). Manufacturers have developed this pump system to deliver Concerta throughout the day rather than all at once. This controlled delivery gives people a steady dose of the drug and allows for long term symptom control.

Concerta is available in a less expensive generic form. However, the generic versions do not use the OROS pump delivery system and, therefore, may not have the same effects as Concerta.

To keep the OROS pump delivery system intact, people cannot chew or crush the Concerta tablets. As a result, the tablets may not be suitable for children who cannot swallow pills.

Concerta is available in tablets of the following strengths:

  • 18 milligrams (mg)
  • 27 mg
  • 36 mg
  • 54 mg

A doctor will usually start by prescribing the lowest possible dosage, increasing it only if necessary.

Doctors prescribe Concerta to treat the symptoms of ADHD because it acts as a stimulant that increases the levels of norepinephrine and dopamine in the brain.

Norepinephrine and dopamine are two chemicals in the brain that have an association with ADHD symptoms.

Concerta has approval for the treatment of ADHD in people between 6 and 65 years old.

The generic name of the drug Vyvanse is lisdexamfetamine. Doctors prescribe Vyvanse to treat ADHD and moderate-to-severe binge eating disorder in adults.

The body breaks down lisdexamfetamine into dextroamphetamine after a person swallows it. This compound has stimulating effects on the brain, but doctors are unsure exactly how it treats symptoms of ADHD or binge eating disorder.

Vyvanse is available in both a capsule and chewable form. Vyvanse capsules are available in the following strengths:

  • 10 mg
  • 20 mg
  • 30 mg
  • 40 mg
  • 50 mg
  • 60 mg
  • 70 mg

Vyvanse chewable tablets are available in the following strengths:

  • 10 mg
  • 20 mg
  • 30 mg
  • 40 mg
  • 50 mg
  • 60 mg

Doctors will prescribe a starting dosage of 30 mg once daily in the morning for people 6 years or older with ADHD.

If this initial dosage is not providing symptom relief, the doctor may raise the daily dose by 10 or 20 mg each week.

To treat binge eating disorder, people can start with a dosage of 30 mg per day. The doctor can increase the daily dose by 20 mg weekly until it reaches 50–70 mg per day.

The maximum daily dose of Vyvanse for ADHD or binge eating disorder is 70 mg.

Vyvanse vs. Adderall: Differences, similarities, and which one is better for you

Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ

Adderall and Vyvanse are stimulant medications approved by the Food and Drug Administration (FDA) to treat patients with adult ADHD or childhood ADHD. Adderall is also used to treat narcolepsy in adults or children; Vyvanse is also used for moderate to severe binge eating disorder (BED) in adults.

Adderall contains the chemical dextroamphetamine/amphetamine (also called amphetamine salts). Vyvanse contains lisdexamfetamine dimesylate, which is known as a prodrug because it starts out as lisdexamfetamine and is converted to its active form, dextroamphetamine, in the GI tract and liver. This mechanism lowers the abuse potential of Vyvanse. Both Adderall and Vyvanse are Schedule II drugs, meaning there is a high potential for abuse.

Both drugs are typically covered by insurance. Adderall and Adderall XR (extended-release, or long-acting) are available in brand and generic, while Vyvanse is currently only available as a brand-name drug.

What are the main differences between Adderall and Vyvanse?

Adderall

Adderall is a central nervous system stimulant drug used in the treatment of ADHD and narcolepsy in adults and children. It comes in an immediate-release and extended-release capsule (XR) form; both are available in brand and generic. The generic name is dextroamphetamine/amphetamine.

Adderall is usually covered by insurance but using the generic is often more cost-effective. This medication is usually taken two or three times a day; each dose lasts about four hours. Adderall XR is taken once a day and can last eight to 12 hours.

Adderall comes with many side effects, drug interactions, and warnings, many of which can be managed with careful monitoring and continuous evaluation.

Vyvanse is a central nervous system stimulant drug used in the treatment of ADHD in adults and children, and for moderate to severe binge eating disorder in adults. Vyvanse comes in a capsule form and a chewable tablet and is available in brand only. Vyvanse is usually covered by insurance but because it’s available in brand only, patients may have a higher copay, although every insurance is different.

The chemical name of Vyvanse is lisdexamfetamine, and the drug turns into dextroamphetamine in the GI tract. Because of this mechanism, it may be less likely to be abused than Adderall. Vyvanse is taken once daily in the morning; a dose can last up to 14 hours.

Like Adderall, Vyvanse comes with many side effects, drug interactions, and warnings, many of which can be managed with careful monitoring and continuous evaluation.

Main differences between Adderall and Vyvanse
Adderall Vyvanse
Drug Class CNS Stimulant CNS Stimulant
Brand/generic status Brand and generic available Brand only
What is the generic name? Dextroamphetamine/amphetamine Lisdexamfetamine dimesylate
What form does the drug come in? Tablet: 5, 7.5, 10, 12.5, 15, 20, 30 mg

(Also comes in an extended-release (XR) tablet)

Capsules: 10, 20, 30, 40, 50, 60, 70 mg

Chewable: 10, 20, 30, 40, 50, 60 mg

What is the standard dosage? (Doses vary; examples provided are average doses) ADHD in adults: 5 to 40 mg per day, divided once, twice, or 3 times daily

Narcolepsy in adults: 5 to 60 mg per day, divided once, twice or 3 times daily

ADHD in children:

3-5 years old: 2.5 to 40 mg per day divided once, twice, or 3 times daily

6 years and older: 5 to 40 mg per day divided once, twice, or 3 times daily

Narcolepsy in children:

6 years old and up: 5 to 60 mg per day divided once, twice, or 3 times daily

ADHD in adults or children (6 and older): 30 to 70 mg once daily in the morning (maximum dose is 70 mg per day)

Binge eating disorder (moderate to severe) in adults: 50 to 70 mg every morning (may start at 30 mg and increase; maximum dose is 70 mg per day)

How long is the typical treatment? Not studied for long-term use, patients should be frequently evaluated. Package insert comes with a warning: “Administration of amphetamines for prolonged periods of time may lead to drug dependence and must be avoided.” Not studied for more than 4 weeks; patients should be closely monitored while on Vyvanse. Package insert comes with a warning: “Administration of amphetamines for prolonged periods of time may lead to drug dependence and must be avoided.”
Who typically uses the medication? Adults or children with ADHD or narcolepsy Adults with ADHD or moderate to severe binge-eating disorder; children with ADHD

Conditions treated by Adderall and Vyvanse

Adderall is used in adults and children for the treatment of ADHD or narcolepsy. Vyvanse is used in adults and children for the treatment of ADHD. It is also used in adults for moderate to severe binge eating disorder.

Condition Adderall Vyvanse
ADHD (children and adults) Yes Yes
Binge-eating disorder (moderate to severe) No Yes
Narcolepsy (children and adults) Yes No

Is Adderall or Vyvanse more effective?

In an analysis of the effectiveness of Adderall, published in the Journal of Attention Disorders, six studies were reviewed. Adderall was found to be significantly effective for symptoms of inattention, hyperactivity, impulsivity, and aggression. A clinical study of Adderall XR showed significant improvement over placebo in terms of behavior, attention, and hyperactivity.

A 2016 study published in Clinical Drug Investigation found Vyvanse to be beneficial in children, adolescents, and adults with ADHD. In a study published in JAMA Psychiatry in 2017, Vyvanse was found to be useful in preventing relapse of binge-eating disorder. Only 3.7% of Vyvanse patients relapsed, compared to 32.1% of patients taking a placebo.

Both drugs have been shown to be effective; however, everyone reacts differently to medications. Consult with your doctor about which medication may be more appropriate for you or your child.

Coverage and cost comparison of Vyvanse vs. Adderall

Insurance usually covers Adderall (brand and generic) and Vyvanse; some insurances actually prefer brand-name Adderall XR over the generic alternative, due to insurance contracts.

You can save on prescription drugs with SingleCare coupons; click the links to check out our savings on Adderall and Vyvanse.

Adderall Vyvanse
Typically covered by insurance? Yes Yes
Typically covered by Medicare Part D? Usually; copay will vary Rarely; Vyvanse is usually non-preferred and has a high out-of-pocket cost for Medicare D patients
Standard dosage Example: generic Adderall 20 mg, 60 count, taken as 1 tablet twice a day Example: 50 mg, 30 count, taken once daily in the morning
Medicare Part D copay $7-78; varies $42-349; varies
SingleCare Cost $31 $313

Common side effects of Adderall vs. Vyvanse

Side effects of Adderall:

In ages six to 12, the most common side effects are loss of appetite, insomnia, stomach pain, mood changes, vomiting, nervousness, nausea, and fever.

In adolescents ages 13 to 17, the most common side effects are loss of appetite, sleep disorder, abdominal pain, weight loss, and nervousness.

In adults, the most common side effects are dry mouth, loss of appetite, insomnia, headache, weight loss, nausea, anxiety, agitation, dizziness, tachycardia (rapid heartbeat), diarrhea, weakness, and urinary tract infections.

Side effects of Vyvanse:

The most common side effects in children, adolescents, and/or adults with ADHD are anorexia, anxiety, decreased appetite, decreased weight, diarrhea, dizziness, dry mouth, irritability, insomnia, nausea, upper abdominal pain, and vomiting.

The most common side effects in adults with BED are dry mouth, insomnia, decreased appetite, increased heart rate, constipation, feeling jittery, and anxiety.

Consult your healthcare professional for more information on side effects.

Drug Interactions of Vyvanse vs. Adderall

Adderall and Vyvanse have a very similar drug interaction profile.

Tricyclic antidepressants, such as Elavil (amitriptyline) or Pamelor (nortriptyline) may increase the cardiovascular side effects of Adderall or Vyvanse; patients should be closely monitored.

Paxil (paroxetine) or Prozac (fluoxetine) are SSRI antidepressants that may increase the risk of serotonin syndrome when taken with Adderall or Vyvanse. SNRI antidepressants such as Effexor (venlafaxine) may also pose the same risk of serotonin syndrome when taken with Adderall or Vyvanse.

Monoamine oxidase inhibitors (MAOIs), such as selegiline, in combination with Adderall or Vyvanse, can cause a hypertensive crisis, and lead to death. MAOIs should not be used within 14 days of Adderall or Vyvanse. Adderall or Vyvanse may also interact with blood pressure medicines.

Drug Drug Class Adderall Vyvanse
Prozac (fluoxetine)

Paxil (paroxetine)

Celexa (citalopram)

Zoloft (sertraline)

Lexapro (escitalopram)

SSRI antidepressants Yes Yes
Elavil (amitriptyline)

Pamelor (nortriptyline)

Tricyclic antidepressants Yes Yes
Effexor (venlafaxine), Pristiq (desvenlafaxine), Cymbalta (duloxetine) SNRI antidepressants Yes Yes
Desyrel (trazodone), Wellbutrin (bupropion) Other antidepressants Yes Yes
Selegiline, tranylcypromine MAO inhibitors Yes Yes
Blood pressure medications All categories Yes Yes
Axert (almotriptan), Imitrex (sumatriptan), Maxalt (rizatriptan), Zomig (zolmitriptan), Relpax (eletriptan) Selective serotonin receptor agonists for migraine Yes Yes
Prevacid (lansoprazole), Prilosec (omeprazole), Protonix (pantoprazole) PPI (Proton pump inhibitors) Yes Yes

This is a partial list. Consult your healthcare provider for an individualized evaluation of drug interactions with your medications.

Warnings of Vyvanse and Adderall

Adderall and Vyvanse have the same warnings:

  • Strong warning for misuse/abuse, especially with prolonged use. Misuse can also cause sudden death or heart problems and other serious cardiovascular side effects in patients.
  • Sudden death has been reported, even with usual doses. Adults and those with cardiac abnormalities or any serious cardiac problems are at higher risk.
  • Blood pressure may increase, usually only slightly, but sometimes significantly. Patients should be monitored.
  • Preexisting psychosis may be aggravated. Patients should also be monitored for other mental health symptoms, such as aggression.
  • Children should be monitored for growth suppression.
  • Seizure threshold may be lowered.
  • Visual disturbance may occur.
  • Patients should be evaluated for Raynaud’s phenomenon (limited circulation to extremities).
  • Serotonin syndrome may occur. Patients should be carefully monitored and seek emergency treatment if any of these symptoms occur:
    • Mental status changes (agitation, hallucinations, delirium, and coma)
    • Rapid heartbeat, fluctuating blood pressure, dizziness, sweating, flushing
    • Tremor, rigidity, incoordination
    • Seizures
    • Gastrointestinal symptoms (nausea, vomiting, diarrhea)

Frequently asked questions about Vyvanse vs. Adderall

What is Adderall?

Adderall is a stimulant used to treat ADHD in adults and children and narcolepsy in adults and children.

Vyvanse is a stimulant used to treat ADHD in adults and children and moderate to severe binge eating disorder in adults.

Are Vyvanse and Adderall the same?

They are very similar with similar side effects, drug interactions, and warnings. Dosing and pricing vary. One difference between Vyvanse and Adderall is that Vyvanse is a prodrug, and converts to dextroamphetamine in the GI tract, which lowers the potential for abuse.

Which is better: Adderall or Vyvanse?

It depends. Everyone has different reactions to different medications. Your doctor can help you pick the drug that is right for you, based on your individual medical history and needs. For example, if cost is a determining factor, Adderall may be a better choice. And if you are worried about abuse, Vyvanse may be a better bet.

Can I use Adderall or Vyvanse while pregnant?

No. Adderall and Vyvanse should both be avoided while pregnant or breastfeeding. If you become pregnant while already on this medication, consult your prescriber immediately for advice.

Can I use Adderall or Vyvanse with alcohol?

No. Both medications are very dangerous to mix with alcohol.

Adderall: Too much alcohol can increase heart rate and blood pressure, which can be even more dangerous in combination with Adderall. It can even lead to a heart attack or stroke and increase the risk of alcohol poisoning.

Vyvanse: Alcohol can minimize some of the stimulant effects of Vyvanse, and Vyvanse can reduce some of the sedating effects of alcohol. As a result, the person may try to use more of one or both drugs and end up overdosing.

There are many other effects that can result from mixing alcohol with Vyvanse, such as: dramatic change in blood pressure, increased heart rate, chest pains, heart attack, stroke, risk of seizures, aggression, paranoia, confusion, hallucinations, and more.

Additionally, alcohol may worsen ADHD.

Does Vyvanse have less side effects than Adderall?

The side effects are very similar and may include: dry mouth, loss of appetite, insomnia, headache, weight loss, nausea, anxiety, agitation, dizziness, tachycardia, and diarrhea, among other side effects.

Can you mix Adderall and Vyvanse?

No. The additive effects can cause rapid heartbeat, high blood pressure, or other side effects. It is also duplicate therapy and not necessary to use both.

How much Vyvanse is equal to Adderall?

There are various applications for healthcare professionals to use to convert the dosing between medications, if necessary. Dosing conversions may not be exact, and it may take a little bit of trial and error when switching between these medications.

Remember, the most effective medication should only be determined by your doctor who will look at the whole picture of your medical condition(s), health history, and other medications that could interact with Vyvanse or Adderall

General Information

Vyvanse is a pro-drug of dextroamphetamine. It works primarily by inducing the release of the neurotransmitters dopamine and norepinephrine from their storage areas in nerve terminals. Both of these transmitters contribute to maintaining alertness, increasing focus, and sustaining thought, effort, and motivation.

Vyvanse is specifically indicated for the treatment of Attention Deficit/Hyperactivity Disorder in pediatric populations aged 6 to 12 years.

Vyvanse is supplied in 30 mg, 50 mg or 70 mg oral capsules designed for once daily oral administration. The recommended initial dose of the drug for this population is 30 mg once daily in the morning. This dose may be escalated beyond 30 mg/day, by adjusting in increments of 20 mg/day and at approximately weekly intervals. The maximum recommended dose is 70 mg/day.

Clinical Results

FDA Approval
FDA approval of Vyvanse was based on the results of two clinical trials.

Trial 1
This double-blind, randomized, placebo-controlled, parallel-group trial enrolled 290 children, ages 6-12, who met the DSM-IV criteria for ADHD. The subjects were placed into fixed dose treatment groups and received final doses of 30, 50, or 70 mg of Vyvanse or placebo once daily in the morning, for four weeks. Significant improvement in behavior, as measured by the ADHD Rating Scale, was the primary endpoint. This was achieved for all Vyvanse treatment groups when compared to placebo. These effects were maintained throughout the day based on parents rating (Connor’s Parent Rating Scale).

Trial 2
This double-blind, placebo-controlled, randomized, crossover design trial enrolled 52 children, ages 6-12, who met the DSM-IV criteria for ADHD. Following a 3-week open-label dose titration with Adderall XR, subjects were randomly assigned to continue the same dose of Adderall XR (10, 20, or 30 mg), Vyvanse (30, 50, and 70 mg), or placebo once daily in the morning for 1 week each treatment. Based upon the average of investigator ratings on the Swanson, Kotkin, Agler, M.Flynn and Pelham (SKAMP)-Deportment scores across the 8 sessions of a 12 hour treatment day, a significant improvement in behavior was observed in all the Vyvanse groups when compared to placebo.

Side Effects

Adverse events associated with the use of Vyvanse may include, but are not limited to, the following:

  • Decreased Appetite
  • Insomnia
  • Upper Abdominal Pain
  • Headache
  • Irritability
  • Vomiting
  • Decreased Weight
  • Nausea
  • Dry Mouth

Vyvanse is classified as a Schedule II controlled substance due to the potential for abuse and dependence.

Mechanism of Action

Vyvanse is a pro-drug of dextroamphetamine. Amphetamines are thought to block the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase the release of these monoamines into the extraneuronal space. Norepinephrine and dopamine contribute to maintaining alertness, increasing focus, and sustaining thought, effort, and motivation. However, the exact therapeutic action in ADHD is not known.

Literature References

Spencer TJ, Wilens TE, Biederman J, Weisler RH, Read SC, Pratt R Efficacy and safety of mixed amphetamine salts extended release (Adderall XR) in the management of attention-deficit/hyperactivity disorder in adolescent patients: a 4-week, randomized, double-blind, placebo-controlled, parallel-group study. Clinical therapeutics 2006 Feb;28(2):266-79.

Ambrosini PJ, Sallee FR, Lopez FA, Shi L, Michaels MA; LADD.CAT Study Group A community assessment, open-label study of the safety, tolerability, and effectiveness of mixed amphetamine salts extended release in school-age children with ADHD. Current medical research and opinion 2006 Feb;22(2):427-40.

Kramer WG, Read SC, Tran BV, Zhang Y, Tulloch SJ Pharmacokinetics of mixed amphetamine salts extended release in adolescents with ADHD. CNS spectrums 2005 Oct;10(10 Suppl 15):6-13.

Gillberg C, Melander H, von Knorring AL, Janols LO, Thernlund G, Hagglof B, Eidevall-Wallin L, Gustafsson P, Kopp S Long-term stimulant treatment of children with attention-deficit hyperactivity disorder symptoms. A randomized, double-blind, placebo-controlled trial. Archives of general psychiatry 2001 Dec;58(12):1184.

Additional Information

For additional information regarding Vyvanse or Attention Deficit/Hyperactivity Disorder, please visit the Vyvanse web page.

Generic Name: lisdexamfetamine (lis dex am FET a meen)
Brand Names: Vyvanse

Medically reviewed by Sophia Entringer, PharmD Last updated on Jan 4, 2019.

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Vyvanse (lisdexamfetamine) is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control.

Vyvanse is FDA-approved to treat attention deficit hyperactivity disorder (ADHD) in adults and in children who are at least 6 years old.

Vyvanse is also used to treat moderate to severe binge eating disorder in adults. This medicine is not to be used for obesity or weight loss.

Important information

Vyvanse may be habit-forming, and this medicine is a drug of abuse. Tell your doctor if you have had problems with drug or alcohol abuse.

Stimulants have caused stroke, heart attack, and sudden death in people with high blood pressure, heart disease, or a heart defect.

Do not use Vyvanse if you have used a MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Vyvanse may cause new or worsening psychosis (unusual thoughts or behavior), especially if you have a history of depression, mental illness, or bipolar disorder.

You may have blood circulation problems that can cause numbness, pain, or discoloration in your fingers or toes.

Call your doctor right away if you have: signs of heart problems–chest pain, feeling light-headed or short of breath; signs of psychosis–paranoia, aggression, new behavior problems, seeing or hearing things that are not real; signs of circulation problems–unexplained wounds on your fingers or toes.

Before taking this medicine

You should not use Vyvanse if you are allergic to lisdexamfetamine or any component of the formulation.

Do not use Vyvanse if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Stimulants have caused stroke, heart attack, and sudden death in certain people. Tell your doctor if you have:

  • heart problems or a congenital heart defect;

  • high blood pressure; or

  • a family history of heart disease or sudden death.

To make sure this medicine is safe for you, tell your doctor if you or anyone in your family has ever had:

  • depression, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions;

  • kidney disease;

  • coronary artery disease (clogged arteries);

  • blood circulation problems in the hands or feet; or

  • drug or alcohol addiction.

Some medicines can interact with lisdexamfetamine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

It is not known whether Vyvanse will harm an unborn baby. However, taking the medicine during pregnancy can cause premature birth, low birth weight, withdrawal symptoms, and possible toxic effects in the newborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Lisdexamfetamine can pass into breast milk and may cause side effects in the nursing baby. You should not breast-feed while using this medicine.

Vyvanse is not FDA-approved to treat ADHD in a child younger than 6 years old. Vyvanse is not FDA-approved to treat binge eating disorder in anyone younger than 18 years old.

How should I take Vyvanse?

Take Vyvanse exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Lisdexamfetamine may be habit-forming. Never share Vyvanse with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Take Vyvanse with or without food, first thing in the morning.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

The chewable tablet must be chewed before you swallow it.

Do not crush, chew, break, or divide a Vyvanse capsule. Swallow the capsule whole.

To make swallowing easier, you may open the capsule and sprinkle the medicine into a glass of water or orange juice, or mix it with yogurt. After the medicine has dissolved, drink or eat the mixture right away. Do not save for later use.

While using this medicine, your doctor will need to check your progress at regular visits. Tell any doctor who treats you that you are using this medicine.

Store at room temperature away from moisture, heat, and light. Keep track of your medicine. Vyvanse is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Throw away unused or expired Vyvanse in a sealed container or bag. Ask your pharmacist where to locate a community pharmaceutical take back disposal program.

What happens if I miss a dose?

Take the missed dose as soon as you remember, but not late in the day. Skip the missed dose if it is almost evening. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of lisdexamfetamine can be fatal.

Overdose symptoms may include restlessness, tremor, muscle twitches, rapid breathing, hostility, violence, panic, muscle pain or weakness, and dark colored urine. These symptoms may be followed by depression and tiredness. Overdose may also cause seizure or coma.

What should I avoid while taking Vyvanse?

Vyvanse may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Vyvanse side effects

Get emergency medical help if you have signs of an allergic reaction to Vyvanse: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • signs of heart problems – chest pain, trouble breathing, pounding heartbeats or fluttering in your chest, feeling like you might pass out;

  • signs of psychosis – hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia; or

  • signs of circulation problems – numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Vyvanse can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine.

Common Vyvanse side effects may include:

  • dry mouth, loss of appetite, weight loss;

  • sleep problems (insomnia);

  • fast heart rate, feeling jittery;

  • dizziness, feeling anxious or irritable; or

  • nausea, vomiting, stomach pain, diarrhea, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Vyvanse?

Ask your doctor before using a stomach acid medicine (including Alka-Seltzer or sodium bicarbonate). Some of these medicines can change the way your body absorbs lisdexamfetamine, and may increase side effects.

Other drugs may interact with lisdexamfetamine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Vyvanse only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 8.01.

Related questions

  • Ritalin vs Vyvanse – What’s the difference between them?
  • Adderall vs Vyvanse – What’s the difference between them?

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  • ADHD
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Are There Risks of Long-Term Damage From Abusing Vyvanse?

Vyvanse (lisdexamfetamine dimesylate) is a prescription stimulant medication primarily used to treat ADHD (attention-deficit hyperactivity disorder) in both adults and children and to treat moderate to severe binge eating disorder.1 People generally take one Vyvanse pill each day, usually in the morning.2 Vyvanse is designed in a way that provides a measure of protection against abuse. However, abuse is still possible. Some may misuse the drug to enhance cognitive performance—for example, while studying.

Long-term effects of abuse can include addiction, heart problems, psychosis, paranoia, and seizures.

Vyvanse’s Abuse Potential

Unlike other drugs that treat ADHD, including Ritalin and Adderall, Vyvanse’s unique chemical design means that it is activated in the body in a different way than other stimulant drugs.

Vyvanse is classified as a prodrug. These substances are chemically modified versions of pharmaceuticals that must first undergo an enzymatic conversion to become an active form of the drug.3

Even though an abuse deterrent has been engineered into the medication, some potential for Vyvanse abuse exists.

When someone is looking to amplify the effects of a drug, especially prescription drugs with extended-release mechanisms, one of the most common methods used to enhance the “high” is to crush a pill or open a capsule and snort the powder or dissolve it in a solution for needle use.

But because Vyvanse requires a rate-limited step of enzymatic conversion to become active amphetamine, it may be harder for users to achieve the desired surge of euphoria, even if they snort or inject it.3 In fact, a study in the Journal of Psychopharmacology found that when Vyvanse was administered via injection in doses as high as 50mg, it did not produce significant euphoric effects. On a “drug likability” scale, subjects felt a much greater drug-like “rush” from d-amphetamine than from Vyvanse. The study also noted that it was very difficult to extract the active amphetamine from the product through crushing.4

This could, therefore, discourage people from abusing it. The journal Pharmacy and Therapeutics noted that Vyvanse’s structure as a prodrug may offer a lower potential for abuse and reduces the risk of food or drug interactions. It is also the only stimulant with FDA-approved abuse-deterrent labeling.5,6

Despite this, lisdexamfetamine remains an amphetamine stimulant. Even though an abuse deterrent has been engineered into the medication, some potential for abuse of Vyvanse exists—primarily by ingesting larger than prescribed doses.

Signs of Vyvanse Abuse

Signs that someone may be abusing Vyvanse include:7

  • Dilated pupils.
  • Sweating.
  • Flushed skin.
  • Reduced appetite.
  • Stomach pain.
  • Vomiting.
  • Hyperactivity.
  • Restlessness.
  • Insomnia.
  • Shaking.
  • Poor coordination.
  • Anxiety.
  • Hostility.
  • Suicidal or homicidal thoughts.

An overdose of Vyvanse can include symptoms such as:2

  • Fever.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Stomach cramps.
  • Muscle aches.
  • Weakness.
  • Restlessness.
  • Tremors.
  • Hallucinations.
  • Confusion.
  • Aggression.
  • Panic.
  • Rapid breathing.
  • Fast or irregular heart rate.
  • Loss of consciousness.
  • Coma.

Ingesting a large amount of Vyvanse can potentially be fatal and lead to seizures and heart failure.8

Long-Term Risks of Abuse

Although Vyvanse is somewhat more difficult to abuse than other prescription stimulant drugs, it’s not impossible. By taking more than the recommended dose, users can experience a range of serious, negative impacts on their health in the long run.

For example, misuse of central nervous system stimulants such as Vyvanse can hasten the development of tolerance, physiological dependence, and addiction. Some degree of tolerance and dependence may develop even in people who take the drug as prescribed.

  • With tolerance, the drug’s effects become less pronounced over time. Someone who has built tolerance to a drug may require higher and higher doses to achieve the desired effect.
  • Dependence means a person’s system adapts to the presence of the drug and only functions normally when the drug is present. When the person stops taking the drug, they can experience withdrawal symptoms.
  • Addiction is compulsive, drug-seeking behavior that may interfere with several aspects of the person’s life, such as their health, job, and relationships.7,8

Vyvanse withdrawal symptoms can include:9

  • Excessive sleeping.
  • Fatigue.
  • Mood swings.
  • Depression.
  • Overeating.
  • Cravings.

Other serious long-term effects of Vyvanse misuse, some of which may be associated with fatalities, include:8,10

  • Chronically elevated blood pressure.
  • Heart palpitations and arrhythmias.
  • Chest pains/heart attack.
  • Stroke.
  • Seizures.
  • Psychotic features—hallucinations, paranoia, delusions.

Misconceptions About ADHD Medications

Unfortunately, abuse of ADHD medications is widespread, especially among young people.

Many students who do not have ADHD take stimulant medications with the belief that the drugs will improve their academic performance or augment their cognitive skills. Studies have found that the rate of prescription stimulant abuse among college students is as high as 17%.11 Another study done by a researcher at the University of Kentucky found that 30% of the students at that school had misused ADHD medications to help them study.12

The Monitoring the Future (MTF) survey tracks middle and high school students, studying their behaviors, actions, and attitudes in a wide variety of areas. In 2018, MTF researchers determined that 1.8% of 8th graders, 4.1% of 10th graders, and 4.6% percent of 12th graders had misused Adderall at some point in their lives.13

Despite misuse to enhance cognitive performance, evidence is mixed on whether these drugs actually improve performance.

  • One study found that stimulant medications can improve some cognitive functioning in people who do not have ADHD.14
  • Another study found that the drugs can improve cognitive deficits, such as in memory, but not performance. And they do not increase IQ.15
  • Finally, a 2018 study found that Adderall have little impact on cognitive performance in non-ADHD college students.16

If you or someone you know is abusing Vyvanse, talk to your doctor or consider getting help at a drug rehabilitation program. Quitting the drug can prevent long-term effects on your health and help you avoid potentially severe consequences, such as overdose.

More on Long-Term Effects

  • Permanent Effects of Drug Use
  • Kratom
  • Lunesta
  • Marijuana
  • Methadone
  • PCP
  • Phenobarbital
  • Valium

Sources

. National Alliance on Mental Illness. Amphetamine (Vyvanse).

. U.S. National Library of Medicine, Medline Plus. (2016). Lisdexamfetamine.

. Food and Drug Administration. (2017). VYVANSE (lisdexamfetamine dimesylate) capsules, for oral use, CII.

. National Institute on Drug Abuse. (2018). Prescription Stimulants.

. Government of South Australia. Amphetamine Withdrawal Management.

. Reynolds, J. (2017). Why It’s Risky for College Kids to Take ADHD Meds to Help Them Study. U.S. News and World Report.

. Cooper, A. (2011). College students take ADHD drugs for better grades. CNN.

. National Institute on Drug Abuse. Monitoring the Future Study: Trends in Prevalence of Various Drugs.

Effects and Side Effects of Vyvanse Abuse

  1. Immediate Effects and Adverse Effects of Vyvanse Use
  2. Long-Term Effects of Vyvanse Use
  3. How Vyvanse Abuse Can Change your Life
  4. Vyvanse Addiction and Mental Health

Vyvanse is a prescription stimulant used in the treatment of ADHD (Attention-Deficit Hyperactivity Disorder) in children, teens and adults. It is also used to treat Binge Eating Disorder.

Vyvanse contains d-amphetamine (or lisdexamfetamine) that is similar in effects to Ritalin and Adderall.

It is a Schedule II drug—considered dangerous with potential for severe psychological or physical dependence.

Immediate Effects and Adverse Effects of Vyvanse Use

Effects are different for users with ADHD and those without the disorder.

Effects for People With ADHD

Vyvanse increases:

  • Focus.
  • Organization.
  • Sleep.
  • Task completion.

Vyvanse decreases:

  • Agitation.
  • Sense of being driven to move or talk.
  • Social intrusiveness.
  • Impulsive behavior.
  • Distractibility.

Effects for People Without ADHD

  • Increased energy
  • Decreased need for food and sleep
  • Euphoria
  • Talkativeness
  • Anxiety
  • Irritability

Long-Term Effects of Vyvanse Use

Cravings

Cravings for Vyvanse lead to drug-seeking behavior. They are triggered by changes in the brain and its reward centers having been influenced by previous positively reinforcing stimulant use, and the resultant drive to reach such a rewarded state again (by taking more lisdexamfetamine, for example).

Psychological discomfort and stress also trigger an urge to use. Other triggers that cause cravings are reminders in the environment.

These can be something you see, hear or smell. Additionally, being with people or in places related to use is an ongoing struggle because it frequently triggers craving.

Dependence

There has been some controversy about the potential for abuse and addiction in Vyvanse use. Treatment professionals see evidence of it while some studies disagree. The active ingredient in Vyvanse, however, is a highly addictive stimulant (d-amphetamine). It is well established that moderate, chronic or severe short-term use of stimulants can lead to dependence. For example, teens that begin medical use of a stimulant in high school are 3 times more likely to abuse it than non-users. College students are also more likely than high school students to develop dependence because of the increased vulnerability to use, due to academic performance pressures and abundant peer influences.

Tolerance

Tolerance is the need for increasing amounts of a drug over time to produce the desired effects. Tolerance in medical use triggers raised doses to manage symptoms more effectively.

In Vyvanse misuse, tolerance means that more is needed over time to achieve the desired high.

Withdrawal

Withdrawal from Vyvanse is similar to cocaine withdrawal. Cessation or a lowered dose of Vyvanse in a use disorder causes withdrawal symptoms such as:

  • Oversleeping.
  • Poor coordination.
  • Shaking.
  • Potential for seizures.
  • Dehydration.
  • Tachycardia.
  • Irritability.
  • Mood swings.
  • Depression.
  • Anxiety.

How Vyvanse Abuse Can Change your Life

The abuse of Vyvanse can have pervasive physical, psychological and behavioral effects. If a seemingly endless cycle of cravings, increased tolerance and unpleasant withdrawal is dominating your life, now is the time to seek recovery help.

Call our toll-free, confidential line at 1-888-993-3112Who Answers? to speak with a caring support advisor about Vyvanse abuse treatment programs available to you.

Physical Effects

“Vyvanse Use Disorder seriously impairs sleep and eating with chronic insomnia and malnourishment.”

Stimulant abuse causes abnormalities in:

  • Brain chemistry.
  • Functioning.
  • Structure.

Stimulant Use Disorder or more specifically, Vyvanse Use Disorder is a reflection of these brain changes.

Vyvanse Use Disorder seriously impairs sleep and eating with chronic insomnia and malnourishment. There can also be:

  • Suppressed growth (in young users).
  • Liver damage.
  • Cardiovascular problems.
  • Vision problems.
  • Seizures.
  • Death.

Psychological Effects

Psychological effects of Vyvanse Use Disorder include cognitive impairments such as:

  • Confusion.
  • Disorientation.
  • Psychosis (delusions and hallucinations).
  • Delirium.

Users also experience a ‘delusion of grandeur,’ which is characterized by an over-estimation of one’s abilities and competencies.

Hypervigilance, suspiciousness, and paranoid thinking are typical. Some may experience suicidal or homicidal thinking.

Emotional dysregulation is also common with rapid and notable mood swings including:

  • Depression.
  • Fear.
  • Anger.
  • Tearfulness.
  • Periods of intense pleasure and gregariousness.

Behavioral Effects

Behaviors in Vyvanse Use Disorder are the result of brain changes as well as attempts to continue use, conceal use or to compensate for use. The need to shift or move and talk excessively is an example of classic involuntary behavior. Also, some develop nervous behaviors such as drumming fingers and bouncing legs. Compulsive behaviors initially involving choices such as sex, gambling, and spending can develop. Behaviors also develop as a means of coping with use. For example, reclusive behavior and lying can be attempts to conceal use. Stealing, manipulating or exploiting others can help compensate for a felt need to continue use.

Academic/Occupational Effects

Serious performance problems develop in school or on the job. The inability to focus on and complete tasks causes significant problems that are obvious to others.

They put users at high risk for school failure and loss of employment.

Familial Effects

Preoccupation with using causes noticeable withdrawal from the family. Relationships become estranged or conflictual if one’s use is known, but also due to the user’s impairments.

Social Effects

The effects of Vyvanse Use Disorder can be off-putting in social settings. Hyperactivity, distractibility, and excessive talkativeness, for example, are difficult for others to accommodate.

Vyvanse Addiction and Mental Health

Like other stimulants, Vyvanse can exacerbate psychiatric symptoms such as:

  • Depression.
  • Mania (Bipolar Disorder).
  • Anxiety.
  • Other substance use like alcohol, marijuana, sedatives and painkillers.
  • Psychosis—delusions and hallucinations.

Symptoms of untreated disorders can cause self-medication with Vyvanse. For example, Vyvanse increases energy and can temporarily overcome the lethargy and lack of motivation caused by depression.

Another example occurs with performance or social anxiety in which stimulants can increase a sense of competency in social situations, giving socially inhibited individuals a powerful incentive to use.

Stimulant use mimics psychiatric disorders causing misdiagnosis, obscured drug use and inappropriate treatment. Common diagnostic confusion occurs with:

  • Schizophrenia.
  • Anxiety Disorders.
  • Psychosis.
  • Bipolar Disorder.

It is possible that each of these disorders co-exist with stimulant use. However, stimulant use alone induces the type of symptoms found in each of these disorders.

If you’re concerned that you or someone you love is self-treating an underlying mental health condition with stimulant drugs, or if Vyvanse is worsening the symptoms of depression or other mental health issue, dual diagnosis substance abuse treatment programs will provide the assistance you need.

Call 1-888-993-3112Who Answers? to speak in confidence to a caring treatment support team member about dual diagnosis or other addiction treatment programs available to you.

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