Vyvanse (generic name lisdexamfetamine dimesylate) is a central nervous system (CNS) stimulant that is FDA-approved to treat attention-deficit/hyperactivity disorder (ADHD) and binge eating disorder.
What is Vyvanse?
Vyvanse is a “prodrug” of the CNS stimulant dextroamphetamine, meaning that it is administered orally in an inactive form and requires enzymatic processing in order to become active. The primary mechanism of action is via increasing levels of the neurotransmitters dopamine and norepinephrine, which are associated with enhanced mood and motivation. Vyvanse is associated with a risk of being habit-forming and is classified as a Schedule II drug.
What is Vyvanse Used For?
Vyvanse has FDA-approved and off-label uses, including:
- ADHD: As an ADHD medication, Vyvanse is approved for use in adults and children ages 6 or older to increase attention span and decreases restlessness.
- Binge eating disorder: Although it is not intended as a weight-loss drug, using Vyvanse to treat for binge eating disorder is FDA-approved.
- Vyvanse off label uses: Off-label uses for Vyvanse include weight loss, depression, schizophrenia and excessive daytime sleepiness. It should be noted that the FDA has clearly stated that Vyvanse should not be used as a weight-loss drug.
Vyvanse comes in capsules and chewable tablets in 10 mg, 20 mg, 30 mg, 40 mg, 50 mg and 60 mg formulations. In addition, there is a 70 mg capsule.
Vyvanse Dosage for ADHD
It is typically recommended that the Vyvanse dosage for adults be started at 30 mg, once a day. Dosage may be adjusted incrementally until a maximum dose of 70 mg/day is reached.
Vyvanse Dosage for Binge Eating
The starting dose of Vyvanse for binge eating is 30 mg per day, and it can be incrementally titrated in 20 mg doses in weekly intervals. The recommended target dose is 50 to 70 mg per day, and the maximum dose is 70 mg per day.
Vyvanse Dosage for Child
The Vyvanse ADHD dosage for children ages 6 or older starts at 30 mg per day. Incremental increases should be discussed with your pediatrician.
Vyvanse should be taken in the morning by mouth with or without food. Taking it in the afternoon is not recommended because it may cause insomnia. Methods of administration are as follows:
- Vyvanse Chewable Tablets: Chew Vyvanse chewable tablets completely before swallowing.
- Vyvanse Capsules: Swallow whole with water; alternatively, open the capsule and mix the contents into yogurt, water or orange juice.
How Long Does Vyvanse Stay in Your System?
The Vyvanse half-life was found to be typically less than one hour, although the half-life of its active byproduct, dextroamphetamine, is approximately 12 hours. Consequently, it is expected that Vyvanse and dextroamphetamine would be out of your system within about five hours and 60 hours, respectively.
Alternatives for Vyvanse
There is currently no Vyvanse generic formulation available, but there are other drugs that provide similar effects, including Adderall and Concerta.
Vyvanse vs. Adderall
Pharmacologically, the difference between Vyvanse and Adderall is the chemical makeup of the other compounds they are formulated with. In the case of Vyvanse, the prodrug lisdexamfetamine is metabolized into L- lysine and dextroamphetamine byproducts after consumption. Adderall is a mixture of four amphetamine salts, one of which is dextroamphetamine. Because the primary active component in both medications is dextroamphetamine, they have similar effects. However, differences have been observed in the amount of time it takes for the onset of action: Vyvanse took about three hours to onset and Adderall took about two hours. The effects of both drugs persisted for up to 16 hours. Unlike Vyvanse, Adderall is not approved for binge eating disorder. Vyvanse also may have less risk of misuse than Adderall due to the fact that Vyvanse is only available in a delayed-release formula. However, Vyvanse is associated with a potential for misuse.
Vyvanse vs Concerta
Vyvanse and Concerta have different active compounds, unlike Vyvanse and Adderall. The active component of Concerta is methylphenidate, which is also used in Ritalin. However, because they are both CNS stimulants, they have similar effects. Concerta does not last as long as Vyvanse, with therapeutic effects lasting only 12 hours for Concerta, versus up to 16 hours for Vyvanse. Unlike Vyvanse, Concerta is not approved for binge eating disorder.
What does Vyvanse Look Like?
According to the FDA, Vyvanse chewables and capsules have the following features:
Vyvanse chewable tablets:
- 10 mg: White to off-white, round-shaped tablet; stamped ’10’ on one side and ‘S489’ on the other
- 20 mg: White to off-white, hexagonal-shaped tablet; stamped ’20’ on one side and ‘S489’ on the other
- 30 mg: White to off-white, arc triangular-shaped tablet; stamped ’30’ on one side and ‘S489’ on the other
- 40 mg: White to off-white, capsule-shaped tablet; stamped ’40’ on one side and ‘S489’ on the other
- 50 mg: White to off-white, arc square-shaped tablet; stamped ’50’ on one side and ‘S489’ on the other
- 60 mg: White to off-white, arc diamond-shaped tablet; stamped ’60’ on one side and ‘S489’ on the other
- 10 mg: pink body/pink cap; stamped S489 and 10 mg
- 20 mg: ivory body/ivory cap; stamped S489 and 20 mg
- 30 mg: white body/orange cap; stamped S489 and 30 mg
- 40 mg: white body/blue-green cap; stamped S489 and 40 mg
- 50 mg: white body/blue cap; stamped S489 and 50 mg
- 60 mg: aqua blue body/aqua blue cap; stamped S489 and 60 mg
- 70 mg: blue body/orange cap; stamped S489 and 70 mg
Vyvanse Side Effects
Vyvanse is generally tolerated as well as other CNS stimulants. Vyvanse has similar physical and psychological side effects. Vyvanse can cause dependence. For that reason, it is recommended that Vyvanse be used with caution and only as directed. People who abruptly stop taking stimulants often report symptoms of irritability and a craving for more of the drug. The Vyvanse “crash” refers to symptoms that occur when the drug starts to wear off. Most people take Vyvanse in the morning, so around midday they may feel fatigued or irritable.
Physical Side Effects
Some physical side effects of Vyvanse use include:
- Decreased Appetite: Reported by 27% of users
- Insomnia: Reported by 27% of users
- Dry mouth: Reported by 26% of users
- Diarrhea: Reported by 7% of users
- Nausea: Reported by 7% of users
- Increased blood pressure: Reported by 3% of users
- Excessive sweating: Reported by 3% of users
- Weight loss: Reported by 3% of users
- Erectile dysfunction: Reported by 2.6% of males
Psychological Side Effects
Some psychological side effects of Vyvanse use include:
- Anxiety: Reported by 6% of users
- Anorexia: Reported by 5% of users
- Jittery: Reported by 4% of users
- Agitation: Reported by 3% of users
- Restlessness: Reported by 3% of users
Less commonly reported psychological side effects include:
- Depersonalization (a sense of detachment from self and identity)
- Rapidly Changing Moods
Vyvanse Use Statistics
Since its approval in 2007, Vyvanse prescriptions have become popular, with over 7.5 million prescriptions being written in 2016. Vyvanse was the 99th most commonly prescribed prescription drug in 2016.
Vyvanse should not be taken with monoamine oxidase inhibitors (MAOIs) or within two weeks of stopping MAOIs due to an increased risk of hypertensive crisis (a severe increase in blood pressure that may lead to a stroke) and serotonin syndrome (characterized by agitation, trembling, dizziness and sweating). Make sure your doctor is aware of any prescription, over-the-counter or illicit drugs you may use in conjunction with Vyvanse in order to minimize the risk of dangerous interactions.
- Vyvanse and Alcohol
Vyvanse and alcohol should not be used together. Alcohol is a CNS depressant, and Vyvanse is a CNS stimulant. Combining these classes of drugs can have unpredictable effects on everything from drug and alcohol metabolism to mood and behavior. Furthermore, combining these drugs may negatively affect liver function.
- Vyvanse and Pregnancy
Currently, there is insufficient data on the effects that Vyvanse might have on pregnancy and potential neonatal adverse reactions. Vyvanse is categorized by the FDA as a Category C pregnancy drug, which means that there are no well-controlled human studies to define risk, but there is some data from animal studies indicating that adverse effects may be possible.
Can Vyvanse Get You High?
Vyvanse is designed to minimize the ability for people to get high by using it. Because it is packaged as a prodrug that requires enzymatic processing in the blood to be activated, snorting or routes of administration other than swallowing will be ineffective. In addition, Vyvanse is an extended-release medication, so the possibility of getting an immediate rush is limited. However, it is possible to misuse Vyvanse by taking very large doses by mouth, possibly resulting in a transient, mild euphoria but also causing uncomfortable physical and psychological symptoms like rapid heart rate, nausea and anxiety. If you suspect an overdose, call 911.
Key Points to Understanding Vyvanse
Keep the following key points in mind when considering Vyvanse:
- Vyvanse is a prodrug of the CNS stimulant dextroamphetamine, meaning that it is in an inactive form until it undergoes enzymatic processing in the blood
- Vyvanse is a Schedule II drug, indicating that it is associated with a high risk for abuse
- Vyvanse is FDA-approved to treat ADHD in adults and children and binge eating disorder in adults
- Off-label uses for Vyvanse include treating depression but the FDA has made it clear that Vyvanse is not a weight-loss drug
- Vyvanse comes in chewable tablets and capsules. The initial recommended dose is 30 mg taken once in the morning; if needed, doses can be increased in 10 mg increments until the maximum dose of 70 mg is reached.
- Vyvanse and Adderall have the same major active ingredient (dextroamphetamine), so they have very similar effects; Concerta is a different drug but because it is also a CNS stimulant it has similar effects.
- Vyvanse is generally well tolerated and has a side effect profile similar to other stimulants; physical symptoms may include decreased appetite, dry mouth and insomnia; psychological side effects may include anxiety and restlessness.
- Vyvanse should not be taken with monoamine oxidase inhibitors
- Vyvanse and alcohol should not be used together
- Effects of Vyvanse on fetal development remains unclear
- Vyvanse has little potential to get someone high, but regular use can cause dependence and addictive behaviors
Contact The Recovery Village Palm Beach at Baptist Health to speak with a representative about how professional addiction treatment can help address your substance use disorder.
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