Vyvanse is a popular prescription central nervous system (CNS) stimulant that is FDA-approved to treat ADHD and binge eating disorder in adults. People also use Vyvanse off-label to treat depression, lose weight and treat schizophrenia. Vyvanse is classified by the Drug Enforcement Administration as a Schedule II drug, meaning that it has a high potential for abuse. Pharmacologically, Vyvanse is very similar to Adderall but its formulation was engineered in such a way as to limit the high potential for abuse that is associated with Adderall.
Is Vyvanse Addictive?
Vyvanse was formulated to have a lower risk of misuse and abuse than other prescription stimulants. Prior to administration, Vyvanse is in the form of a “prodrug,” meaning that it is inactive and requires enzymatic metabolism in order for the active drug to become available. After oral administration, the prodrug lisdexamfetamine interacts with enzymes in the blood that break the drug into its metabolic byproducts, namely the normally occurring amino acid L-lysine and the active form of the stimulant, dextroamphetamine.
The requirement for metabolism to achieve the desired effect means that common routes of abuse (for example, snorting the powder) do not deliver the potent high that is often associated with other prescription amphetamines. In addition, Vyvanse was formulated as a drug with extended-release capabilities, meaning that the drug is released slowly. These precautions were designed to reduce Vyvanse’s potential for abuse. However, like all stimulants, Vyvanse has been shown to cause tolerance, dependence and addictive behavior when taken regularly. Vyvanse is considered by the FDA and the DEA to have a high potential for abuse and is classified as a Schedule II controlled substance. Vyvanse addiction potential can be minimized by taking the drug exactly as prescribed. Caution should be exercised with long-term regular use. Make sure to discuss whether you have particular risk factors that could lead to dependence or addiction with your doctor.
What Causes Vyvanse Addiction?
Vyvanse causes chemical changes in the brain that are associated with addiction. The primary mechanism of action is increased availability of the neurotransmitters dopamine and norepinephrine in the brain. Dopamine is strongly implicated in the development of dependence and addiction via regulation of the reward pathway. Increased levels of dopamine correlate with increased activation in the reward pathway, which subsequently causes a sense of pleasure or euphoria. Increasing levels of dopamine lead to increasing euphoria. Importantly, activation of the reward pathway is associated with the development of incentive salience, meaning that any stimulus that activates the reward system is attributed with a sense of “want” or “need” that increases in intensity as the stimulus intensity increases. These events are primary causes of drug addiction.
Many drugs, including Vyvanse, are associated with the development of tolerance. Tolerance is a state where ever-increasing amounts of the drug are required to elicit the same effect because, with regular use, the brain adapts to the presence of the drug. Dependence is a consequence of tolerance and is associated with physical withdrawal symptoms when sufficient amounts of the drug are not administered. Addiction is considered to be a behavioral component of dependence and is characterized by compulsive drug-seeking behavior in spite of harmful consequences.
Signs of Vyvanse Addiction
Unlike dependence, which is the presence of withdrawal symptoms in the absence of the drug, addiction is characterized by persistent drug-seeking behavior despite the potential for negative consequences. Signs and symptoms that someone has developed a Vyvanse use disorder include:
- Increasing tolerance to Vyvanse
- Dilated pupils
- Appetite changes
- Flushed skin
- Poor coordination
- Stomach pain
- Dry mouth
- Decreased sex drive
- Using Vyvanse in ways other than prescribed
- Obtaining Vyvanse without a prescription
- Evasive or secretive behavior
- Preoccupation with Vyvanse
- Mood swings
- Changes in motivational state
- Failure to meet expectations at work or school
- An inability to cut down or stop using Vyvanse
- Erratic behavior
- Changes to self-care and personal hygiene
- Intense cravings for Vyvanse
- Engagement in risky behavior in order to obtain or use Vyvanse
Signs of Vyvanse Abuse
Vyvanse abuse is not necessarily associated with addiction. There are physical and behavioral changes that are observable by family and friends that can help identify Vyvanse abuse, including:
- Taking Vyvanse in ways other than as prescribed
- Taking Vyvanse without a prescription
- Mixing Vyvanse with other drugs or alcohol
- Administering Vyvanse in ways other than prescribed (e.g., snorting it)
- Loss of appetite
- Intense focus/concentration
- Sleep disturbances
- Dilated pupils
- Elevated or irregular heart rate
- Changes in daily routines
- Increased sociability
- Withdrawal symptoms
Vyvanse Abuse Statistics
Because Vyvanse is a relatively new prescription drug, reliable statistics on Vyvanse abuse are not yet available. However, Vyvanse is chemically similar to Adderall and other prescription CNS stimulants, so data on CNS stimulant misuse and abuse may be extrapolated to describe likely Vyvanse abuse.
A 2015 meta-analysis evaluated the conclusions made by 30 different studies that evaluated stimulant misuse among college students. They determined that 17% of college students misuse prescription stimulants for recreational purposes and as study aids. A 2018 study of adults found that, of the 6.6% of people with prescriptions for CNS stimulants, 1.9% (5 million people) misused the drug without meeting the criteria for substance use disorders and 0.2% (0.4 million people) met the criteria for substance use disorders.
According to the CDC, males are more likely to misuse prescription stimulants than females. The age group associated with the highest rate of misuse is 18 to 25 year-olds. It is possible that these numbers under-represent the actual prevalence of misuse since many people are reluctant to report that they use stimulants in a way other than was prescribed or that they obtained without a prescription.
Side Effects of Vyvanse Abuse
Vyvanse can have short and long-term side effects. Common side effects of Vyvanse abuse include:
- Short-term side effects: Increased heart rate, weight loss, elevated temperature, shortness of breath, chest pain and dizziness. Severe side effects can be dangerous and include convulsions and psychosis.
- Long-term side effects: Chronic Vyvanse abuse can cause long-lasting, permanent changes, including chemical and structural changes in the brain, development of mental health disorders like depression or psychosis, cardiovascular irregularities and malnourishment.
Vyvanse overdoses occur when people take doses that are higher than their bodies are accustomed to. This most often occurs when people use Vyvanse recreationally (in an attempt to get high) or after a period of abstinence when a high dosage is resumed. Overdoses are far more likely to occur if other drugs or alcohol are consumed with Vyvanse and polysubstance overdoses are far more likely to have poor outcomes. In 2010, 63% of emergency department visits related to prescription stimulants included one (25%) or 2 or more (38%) other drugs, with the most common co-used drugs being anti-anxiety and insomnia medications. The data underscores the importance of not using Vyvanse with other drugs or alcohol.
Stimulants have characteristic signs and symptoms associated with overdose, and Vyvanse overdose can be dangerous, even life-threatening. If you suspect an overdose, call 911 or the American Association of Poison Control Centers: (800) 222-1222.
Vyvanse Overdose Symptoms
Vyvanse overdoses in the absence of other drugs cause uncomfortable signs and symptoms but are generally not life-threatening. However, co-use of Vyvanse with other drugs significantly increases the risk of overdose and the vast majority of deaths associated with prescription stimulants include at least one other drug or alcohol. Vyvanse overdoses are associated with several physical and psychological symptoms:
- Irregular heartbeat
- Overactive reflexes
- Nausea or vomiting
- Erratic behavior
- Rapid respiration
Vyvanse Withdrawal and Symptoms
As with other stimulants, abrupt cessation of Vyvanse is associated with physical and psychological withdrawal symptoms. It is generally recommended that, rather than quitting cold turkey, someone seeking to stop using Vyvanse should taper their dose to minimize the discomfort associated with detoxification and acute withdrawal.
Consultation with a medical professional is the most effective way to plan a safe and effective tapering schedule. Some people choose to participate in a rehab program that is equipped to provide a safe environment that gives people the chance to successfully manage the first days of withdrawal and minimizes the chance of setbacks occurring.
Symptoms of detoxification and acute withdrawal are characterized by profound fatigue, depression, anhedonia and extreme mood swings. People recovering from moderate to severe Vyvanse use disorder may experience post-acute withdrawal syndrome (PAWS). PAWS is a constellation of withdrawal symptoms that persist beyond the acute withdrawal phase. Symptom intensity typically fluctuates but reliably subsides over time, usually weeks or months after cessation.
Key Points to Understanding Vyvanse Addiction
Keep the following key points in mind regarding Vyvanse addiction:
- Vyvanse is a popular prescription drug that is used to treat ADHD in and binge eating disorder
- Vyvanse causes substantial chemical changes in the brain that lead to physical and behavioral changes
- Like other stimulants, Vyvanse is associated with a high risk for the development of dependence and addiction
- Vyvanse abuse is characterized by using the drug in ways other than prescribed or obtaining the drug without a prescription
- Signs of Vyvanse addiction include weight loss, rapid heart rate and disturbed sleep
- Symptoms of Vyvanse addiction include increased energy levels, compulsive drug-seeking behavior and mood swings
- Long term consequences of Vyvanse use disorder can include persistent structural and chemical changes in the brain that lead to mental health disorders, including depression or anxiety disorders and stimulant-induced psychosis
- Vyvanse overdose symptoms include irregular heartbeat, panic, confusion, tremors and erratic behavior. A Vyvanse overdose can be dangerous, especially if other drugs are also being used. If you suspect an overdose, call 911
Contact The Recovery Village Palm Beach at Baptist Health today to speak with a representative and learn how professional addiction treatment can address your substance use disorder.
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Drugs.com. “Vyvanse – How fast does your tolerance build up, how do you recognize the signs & cope with it?” July 2019. Accessed August 19, 2019.
McIntosh, James. “Study finds 17% of college students misuse ADHD drugs.” Medical News Today, March 11, 2015. Accessed August 19, 2019.
Compton, Wilson M; Han, Beth; Blanco, Carlos; Johnson, Kimberly; Jones,Christopher M. “Prevalence and Correlates of Prescription Stimulant Use, Misuse, Use Disorders, and Motivations for Misuse Among Adults in the United States.” The American Journal of Psychiatry, April 2018. Accessed August 19, 2019.
CDC. “2018 Annual Surveillance Report of Drug-Related Risks and Outcomes.” August 2018. Accessed August 19, 2019.
Substance Abuse and Mental Health Services Administration. “The DAWN Report: Emergency Department Visits Involving Attention Deficit/Hyperactivity Disorder Stimulant Medications.” January 2013. Accessed August 20, 2019.
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