Medications

Vyvanse: ADHD Medication

Vyvanse is a stimulant medication used to treat ADHD symptoms in children, adolescents, and adults
Generic Name: Lisdexamfetamine dimesylate (amphetamine)

By Janice Rodden Medically reviewed by ADDitude’s ADHD Medical Review Panel
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What is Vyvanse? Is Vyvanse a Narcotic?

Vyvanse (Generic Name: lisdexamfetamine dimesylate) is a once-daily, timed-release stimulant ADHD medication primarily used to treat attention deficit hyperactivity disorder (ADHD or ADD) in children ages 6-12, adolescents, and adults. Vyvanse is not a narcotic, but according to the FDA, it is a federally controlled substance (CII) because it can be abused or lead to dependence. It is an amphetamine.

Vyvanse may improve focus for people with inattentive ADHD (aka ADD), and decrease impulsivity and hyperactive behavior — hallmark ADHD symptoms for many patients. It is not known if it is safe for children under the age of 6. Vyvanse has been available since 2007, when the FDA approved the medication for the treatment of ADHD.

Vyvanse is also used to treat binge eating disorder in adults.

What’s the Difference Between Vyvanse and Adderall?

Adderall and Vyvanse are both schedule II amphetamine-based central nervous system stimulant medications used to treat ADHD. Adderall comes in both immediate- and extended-release form; Vyvanse is available as an extended-release medication only. The immediate-release version of Adderall has a duration of action of 4 to 6 hours; the extended-release version lasts approximately 12 hours. The duration of effects for Vyvanse is 10 to 14 hours.

Vyvanse is a prodrug – an inert substance that is metabolized in the body to become active – which means it’s side effects are considered less harsh. Both drugs are classified by the FDA as Schedule II stimulants because they can be abused or lead to dependence, however Vyvanse is considered to carry a lower risk since it takes longer to metabolize in the system than does Adderall.

What Is the Best Vyvanse Dosage to Treat ADHD Symptoms?

The optimal dosage of Vyvanse varies by patient. Vyvanse capsules are available in 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, 60mg and 70mg dosages. Vyvanse chewable tablets are available in 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, and 60mg dosages. The time-release formulation is designed to maintain a steady level of medicine in the body throughout the day.

Your doctor may adjust your dosage weekly by 10mg or 20mg increments until you or your child experiences the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects. The maximum dose is typically 70mg daily.

As with all medications, follow your Vyvanse prescription instructions exactly. Vyvanse is taken orally, with or without food, once daily. The first dose is typically taken first thing in the morning; it should be taken at the same time each day for the best results.

Capsules should be swallowed whole with water or other liquids. If your child is unable to swallow the capsule, it can be opened and stirred into yogurt, water, or orange juice. Taken this way, the mixture should be swallowed entirely at once. Chewable tablets should be completely chewed before swallowing, then followed with a glass of water or other liquid.

During treatment, your doctor may periodically ask you to stop taking your Vyvanse so that he or she can monitor ADHD symptoms; check vital statistics including blood, heart, and blood pressure; or evaluate height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

Some patients report developing a tolerance to Vyvanse after long-term use. If you notice that your dosage is no longer controlling your symptoms, talk to your doctor to plan a course of action.

What are the Side Effects of Vyvanse?

Most people taking Vyvanse do not experience any side effects. That said, the most common side effects associated with Vyvanse are as follows:

Vyvanse Side Effects When Treating ADHD:

  • anxiety
  • decreased appetite
  • diarrhea
  • dizziness
  • dry mouth
  • irritability
  • loss of appetite
  • nausea
  • trouble sleeping
  • upper stomach pain
  • vomiting
  • weight loss

Vyvanse Side Effects When Treating Binge Eating Disorder:

  • dry mouth
  • trouble sleeping
  • decreased appetite
  • increased heart rate
  • constipation
  • feeling jittery
  • anxiety

Another serious side effect is slowed growth in children.

Vyvanse and Weight Loss

Vyvanse should not be taken off-label to help you lose weight. Weight loss is not an approved use for this medication.

Vyvanse and Driving

Taking Vyvanse may impair your or your teenager’s ability to drive, operate machinery, or perform other potentially dangerous tasks. This side effect usually wears off with time. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Vyvanse and Heart or Blood Pressure Related Problems

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Vyvanse. Stimulants can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Vyvanse.

Vyvanse and Mental Illness

Disclose to your physician all mental health issues including any family history of suicide, bipolar illness, or depression. The FDA manufacturer recommends evaluating patients for bipolar disorder prior to stimulant administration. Vyvanse may create new or exacerbate existing behavior problems, or bipolar illness. It can cause psychotic or manic symptoms in children and teenagers. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or sudden suspicions.

Vyvanse and Circulation Problems

Discuss circulation problems with your doctor before taking Vyvanse, which has been known to cause numbness, coolness, or pain in fingers or toes, including Raynaud’s phenomenon. Report to your doctor any new blood-flow problems, pain, skin color changes, or sensitivities to temperature while taking Vyvanse.

Vyvanse and Substance Abuse

Stimulants like Vyvanse have a high potential for abuse and addiction, especially among people who do not have ADHD. It is a “Schedule II Stimulant,” a designation that the Drug Enforcement Agency uses for drugs with a high potential for abuse. Other Schedule II drugs include Dexedrine, Ritalin, and cocaine. People with a history of drug abuse should use caution when trying this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Who Can Take Vyvanse? Medication Precautions

You should not take Vyvanse if you are allergic to any of the ingredients in Vyvanse, or if you have taken a monoamine oxidase inhibitor (MAOI) within 14 days.

If you’re thinking of becoming pregnant, discuss the use of Vyvanse with your doctor. It is not known if it can cause fetal harm. Vyvanse is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The safety of Vyvanse for children under age six has not been established. Store Vyvanse in a secure place out of the reach of children, and at room temperature. Do not share your Vyvanse prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

Interactions Associated with Vyvanse

Before taking Vyvanse, discuss all other active prescription medications with your doctor. Vyvanse can have a dangerous, possibly fatal, interaction with antidepressants including MAOIs.

Vyvanse is similar to amphetamine and dextroamphetamine. You should avoid taking these medications concurrently with Vyvanse.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Vyvanse before having any surgery or laboratory tests. Vyvanse can cause false steroid results.

The above is not a complete list of all possible drug interactions.

Vyvanse and Other ADHD Medications: More Information

Sources:

What is Vyvanse. https://www.vyvanse.com/

Allen, Shari. Adderall XR and VyvanseTM. Mental Health Clinician (2014) https://meridian.allenpress.com/mhc/article/4/1/8/37052/Adderall-XRR-and-VyvanseT

Adderall vs. Vyvanse: What’s the Difference? American Addiction Centers (2019). https://americanaddictioncenters.org/adderall/vs-vyvanse

Cardiovascular Effects of Stimulant and Non-Stimulant Medication for Children and Adolescents with ADHD. CNS Drugs (2017). https://link.springer.com/article/10.1007%2Fs40263-017-0410-7

Drelich, Jordan. Is Lisdexamfetamine Dimesylate Safe and Effective in Reducing ADHD Symptoms? Psychiatry Commons (2017). https://digitalcommons.pcom.edu/pa_systematic_reviews/397/