Lisdexamfetamine, known as Vyvanse, is a common medication for ADHD and binge eating disorder in adults. It is approved by the Food and Drug Administration (FDA) for the treatment of attention-deficit/hyperactivity disorder (ADHD) in adults and children, as well as for moderate to severe binge eating disorder (B.E.D.) in adults.
This page provides an overview of how Vyvanse works, its available forms, potential side effects, warnings, and comparisons to other ADHD medications.
What is Vyvanse?
Vyvanse is a prescription stimulant medication containing lisdexamfetamine dimesylate, primarily used to treat ADHD in children and adults, and moderate to severe binge eating disorder in adults [1]. The generic name for Vyvanse is lisdexamfetamine, although generic versions have only recently become available after years of being available only as a brand [2].
Vyvanse came out in 2007 when the FDA first approved it for ADHD treatment in children, with later approvals for adult ADHD and binge eating disorder [3].
Uses
What is Lisdexamfetamine Used For?
Lisdexamfetamine is FDA-approved for two primary conditions: ADHD in patients 6 years and older, and moderate to severe binge eating disorder in adults [1]. For ADHD, the medication helps improve focus, attention, and impulse control by affecting neurotransmitter levels in the brain. In 2015, Vyvanse became the first FDA-approved medication specifically for treating binge eating disorder in adults [4].
Healthcare providers sometimes prescribe lisdexamfetamine off-label for other conditions, though this should only occur under careful medical supervision. The medication works by increasing dopamine and norepinephrine levels in specific brain regions, which helps regulate attention and behavior [5].
How Does Lisdexamfetamine Work (Mechanism of Action)?
Lisdexamfetamine works as a prodrug, meaning it remains inactive until enzymes in the body convert it to dextroamphetamine, which then increases dopamine and norepinephrine levels in the brain [5]. This unique mechanism sets it apart from other ADHD medications.
After you take the medication, red blood cell enzymes break down lisdexamfetamine into dextroamphetamine, the active component [5]. The converted medication then blocks the reuptake of dopamine and norepinephrine while promoting their release from nerve terminals. This process typically provides 10-12 hours of symptom control, allowing for once-daily dosing [1].
How Is Lisdexamfetamine Supplied (Dosage Forms)?
Lisdexamfetamine is available in capsule form in multiple strengths: 10mg, 20mg, 30mg, 40mg, 50mg, and 60mg capsules [6]. Each capsule contains the specified amount of lisdexamfetamine dimesylate as the active ingredient.
The capsules can be swallowed whole or opened and mixed with water, orange juice, or yogurt for those who have difficulty swallowing pills. However, the contents should never be chewed, crushed, or dissolved inappropriately, as this could affect the medication’s extended-release properties and safety profile.
How Should I Store Lisdexamfetamine?
Store lisdexamfetamine at room temperature, between 68°F and 77°F (20°C to 25°C), in its original container, tightly closed, and away from moisture and light. Because this is a controlled substance, secure storage is essential to prevent misuse by others.
Keep the medication in a locked cabinet or safe, especially if children are present in the home. Never share your prescription with others, and properly dispose of unused medication through pharmacy take-back programs or by mixing with unpalatable substances before disposal.
Warnings
Vyvanse carries serious warnings including cardiovascular risks, potential for abuse and dependence, and possible mental health effects [1]. The medication can increase heart rate and blood pressure, potentially causing serious problems in people with existing heart conditions.
Mental health considerations include the possibility of worsening anxiety, panic attacks, or triggering psychotic symptoms like hallucinations in susceptible individuals [1]. The medication carries a black box warning regarding its high potential for abuse and dependence, which is why it’s classified as a Schedule II controlled substance.
Growth suppression can occur in children taking the medication, requiring regular monitoring of height and weight during treatment [1]. Additionally, circulation problems affecting the fingers and toes may develop, causing numbness, pain, or changes in color that require immediate medical attention.
Side Effects of Vyvanse
Common side effects of Vyvanse include decreased appetite, insomnia, dry mouth, irritability, anxiety, dizziness, nausea, and upper abdominal pain. These effects are often dose-related and may improve as your body adjusts to the medication over time.
Serious Side Effects
Serious side effects requiring immediate medical attention include chest pain, shortness of breath, fainting, unexplained wounds on fingers or toes, hallucinations, paranoia, severe mood changes, or aggressive behavior.
Long-term effects are still being studied, but concerns include potential cardiovascular changes and growth suppression in children.
Vyvanse Side Effects In Females & Males
Side effects in females may include additional considerations around pregnancy and breastfeeding, as the medication’s safety during these periods isn’t fully established. Women of childbearing age should discuss family planning with their healthcare provider before starting treatment.
Side effects in males can include changes in sexual function, though this varies significantly among individuals. Some men report decreased libido or erectile dysfunction, while others don’t experience these issues at all.
The National Library of Medicine reports that 39% of children aged 6–12 who took Vyvanse experienced decreased appetite, 22% had insomnia, 12% reported upper abdominal pain, 10% exhibited irritability, and 9% experienced vomiting [7].
Before Taking This Medicine
Before starting Vyvanse, inform your healthcare provider about all medical conditions, especially heart problems, high blood pressure, mental health disorders, seizures, circulation problems, and any history of substance abuse. Certain conditions may make the medication unsafe or require special monitoring during treatment.
Provide a complete list of all medications you’re taking, including prescription drugs, over-the-counter medications, and supplements. Some medications can interact dangerously with lisdexamfetamine, particularly monoamine oxidase inhibitors (MAOIs).
Pregnancy and breastfeeding considerations are essential for women, as the medication’s safety during these periods hasn’t been fully established [1].
Age-related factors also play a role, as dosing and monitoring requirements vary between children, adults, and elderly patients.
How Should I Take Vyvanse?
Take Vyvanse exactly as prescribed, typically once daily in the morning, with or without food. Consistency in timing helps maintain steady medication levels throughout the day and prevents sleep interference.
Swallow capsules whole with water, or open them and sprinkle contents into water, orange juice, or yogurt if swallowing is difficult. Consume the entire mixture immediately and don’t save any for later use. Never chew, crush, or dissolve the contents, as this affects how the medication works.
If your dose seems too low and you’re not experiencing adequate symptom relief, discuss this with your healthcare provider rather than adjusting the dose yourself [1]. Taking the medication late in the day can cause sleep problems, so morning administration is typically recommended.
What Happens If I Miss A Dose?
If you miss a dose, take it as soon as you remember, but only if it’s still early in the day. If it’s afternoon or evening, skip the missed dose and resume your regular schedule the next morning to avoid sleep problems.
Never take two doses at once to make up for a missed dose, as this increases the risk of side effects and potential overdose.
If you frequently forget doses, consider setting daily alarms or using pill organizers to help maintain consistency in your medication regimen.
Contact your healthcare provider if you miss several doses or have questions about managing missed doses, as they may need to adjust your treatment plan.
The FDA-approved Medication Guide warns that “You should not take a higher dose, take it more often, take it for a longer time, or take it in a different way than your doctor has prescribed” and suggests that if pills are missed, one should take them as prescribed at the correct time [8].
What Happens If I Overdose?
A Vyvanse overdose is a medical emergency requiring immediate attention, with symptoms including restlessness, rapid breathing, confusion, hallucinations, irregular heartbeat, and potentially seizures or coma. If overdose is suspected, call 911 or go to the nearest emergency room immediately.
According to the CDC, approximately 34,000 people died from a drug overdose involving psychostimulants with abuse potential in 2022, accounting for nearly 32% of all drug overdose deaths that year [9].
Interactions
Does Lisdexamfetamine Interact With Foods Or Drinks?
Lisdexamfetamine can be taken with or without food, but combining it with large amounts of caffeine can increase side effects like jitteriness and heart palpitations [1]. While food doesn’t significantly affect the medication’s absorption, acidic foods and drinks might slightly reduce its effectiveness.
Alcohol should be avoided while taking this medication, as the combination can mask alcohol’s effects and potentially lead to dangerous levels of consumption. Additionally, alcohol can worsen some side effects and interfere with therapeutic benefits.
High doses of vitamin C supplements may theoretically reduce the effectiveness of the medication. However, normal dietary intake typically poses no concern.
Monitor your total caffeine intake from all sources and discuss typical consumption patterns with your healthcare provider.
Does Lisdexamfetamine Interact with Other Medicines (Drug Interactions)?
The most serious drug interactions occur with MAOIs, which can cause dangerously high blood pressure when combined with lisdexamfetamine. Never take this medication within 14 days of stopping an MAOI without medical supervision.
Blood pressure medications may need dose adjustments when combined with lisdexamfetamine, as the stimulant can increase blood pressure and potentially counteract antihypertensive effects. Regular monitoring is crucial for patients taking both types of medication.
Antidepressants, particularly SSRIs and tricyclic antidepressants, can interact with lisdexamfetamine and may require careful monitoring for side effects and serotonin syndrome.
Over-the-counter medications containing stimulants, such as decongestants and diet pills, can add to the medication’s effects and cause dangerous increases in heart rate and blood pressure.
Related/Similar drugs
Adderall
Adderall contains a mixture of amphetamine salts and is available in both immediate-release and extended-release formulations. In contrast, Vyvanse contains lisdexamfetamine and works as a prodrug. Both medications treat ADHD effectively, but they differ in how they work in the body and their duration of action.
The main difference lies in onset and duration. Adderall becomes active immediately after absorption, while Vyvanse must be converted to its active form, potentially providing smoother effects throughout the day [1].
Adderall XR
Adderall XR is designed for once-daily dosing like Vyvanse, typically lasting 10-12 hours [1]. The choice between these medications often depends on individual response, side effect profile, and cost considerations, as both provide extended symptom control.
Strattera
Strattera (atomoxetine) is a non-stimulant ADHD medication that works differently by selectively inhibiting norepinephrine reuptake. This medication may be preferred for patients who can’t tolerate stimulants or have a history of substance abuse. However, it typically takes longer to show full effects.
Concerta
Concerta contains methylphenidate and uses an osmotic pump system to deliver medication gradually throughout the day. Some patients who don’t respond well to amphetamine-based medications like Vyvanse may do better with methylphenidate-based options.
Ritalin
Ritalin is the immediate-release form of methylphenidate and typically requires multiple daily doses. While effective for many patients, its shorter duration of action makes it less convenient than once-daily options, such as Vyvanse.
Focalin
Focalin contains dexmethylphenidate and is available in both immediate-release and extended-release formulations. Like other methylphenidate-based medications, it may serve as an alternative for patients who don’t respond well to amphetamine-based drugs.
Dexmethylphenidate
Dexmethylphenidate is the active ingredient in Focalin and works by enhancing attention and reducing hyperactivity. It’s more potent than regular methylphenidate, meaning lower doses are often effective. It’s typically used in school-aged children with ADHD, but can also help adults. Available in both short- and long-acting forms, it offers flexibility in symptom management tailored to daily routine needs.
Amphetamine/Dextroamphetamine
Amphetamine/dextroamphetamine is a combination stimulant found in medications like Adderall. It works by boosting dopamine and norepinephrine to improve attention and reduce impulsivity. It acts faster than lisdexamfetamine but may cause stronger peaks and crashes. Often prescribed for both children and adults, it’s effective. Still, it should be closely monitored due to its potential for abuse and dependence.
Atomoxetine
Atomoxetine, the generic name for Strattera, is a non-stimulant ADHD medication. It works by increasing norepinephrine, a brain chemical that affects attention and behavior. It may take several weeks to show results, but it is ideal for patients with anxiety or those who can’t take stimulants. It’s also less likely to be misused and usually doesn’t disrupt sleep.
FAQs
Is Vyvanse stronger than Adderall?
Vyvanse and Adderall have similar effectiveness for treating ADHD, but individual response varies significantly between patients. Neither medication is universally “stronger” than the other, as effectiveness depends on individual brain chemistry, metabolism, and specific symptoms being treated.
What does the drug Vyvanse do?
Vyvanse increases dopamine and norepinephrine levels in the brain, improving attention, focus, and impulse control in people with ADHD [5]. For binge eating disorder, it helps reduce the frequency of binge episodes, though the exact mechanism for this indication isn’t fully understood.
What is the downside of Vyvanse?
The main downsides include potential side effects like appetite suppression and sleep problems, its potential for abuse and dependence, and higher cost compared to some generic alternatives. Other concerns include possible growth suppression in children and cardiovascular effects in susceptible individuals.
What does Vyvanse do for someone?
For individuals with ADHD, Vyvanse helps improve concentration, attention span, and impulse control, making daily tasks and activities more manageable. For adults with binge eating disorder, it reduces the urge to binge eat and decreases episode frequency when used as part of comprehensive treatment.
Why prescribe Vyvanse instead of Adderall?
Healthcare providers might choose Vyvanse due to its smoother, longer-lasting effects and potentially lower abuse potential because of its prodrug design [1]. The medication can’t be crushed and snorted for immediate effects, making it safer for patients with a substance abuse history.
Is Vyvanse good for anxiety?
No, Vyvanse is not approved to treat anxiety and may make it worse in some people. As a stimulant, it can cause nervousness, restlessness, and increased heart rate, which can heighten anxiety symptoms. It is only approved for ADHD and binge eating disorder, not for anxiety-related conditions.
Get Treatment for Addiction at Alliance Recovery
If you are struggling with problematic stimulant use or other substance use disorders, professional help is available. Prescription stimulants like Vyvanse, while medically necessary for many people, can sometimes lead to misuse or dependence.
Here at Alliance Recovery, our executive leadership and admissions staff have extensive knowledge of addiction treatment, with many members of our team having gone through treatment themselves.
When you come to Alliance Recovery, you’ll receive:
Individual and group therapy tailored to your needs
A supportive sober community
Comprehensive aftercare planning and career assistance.
Call our treatment team at (844) 287-8506 to get started.
Sources:
[1] https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021977s050,208510s007lbl.pdf
[2]https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-multiple-generics-adhd-and-bed-treatment
[3] https://www.drugs.com/history/vyvanse.html
[4]https://www.ahdbonline.com/issues/2016/march-2016-vol-9-seventh-annual-payers-guide/2149-vyvanse-lisdexamfetamine-dimesylate-first-fda-approved-drug-for-the-treatment-of-adults-with-binge-eating-disorder-may
[5] https://pmc.ncbi.nlm.nih.gov/articles/PMC2873712/
[6] https://pmc.ncbi.nlm.nih.gov/articles/PMC2873712/
[7] https://www.cdc.gov/overdose-prevention/about/stimulant-overdose.html?
[8] https://medlineplus.gov/druginfo/meds/a607047.html?
[9] https://www.nimh.nih.gov/health/statistics/eating-disorders
