10 Things You Might Not Know About Vyvanse for ADHD

a doctor's prescription pad
Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Vyvanse (lisdexamfetamine), a long-acting stimulant medication used in adults with ADHD, is one of the most commonly prescribed brand-name drugs in the U.S. Given that 60% of adults who were children with ADHD have symptoms that persist to adulthood, long-term treatment may be necessary. If you’re taking Vyvanse long term or thinking about starting it, what are some lesser-known but important things you should know?

  1. In addition to being FDA approved in the U.S. for the treatment of ADHD, Vyvanse was the first medication ever approved for binge eating disorder.
  2. How is Vyvanse different from Ritalin, Adderall, or Concerta? There are two types of stimulants used to treat adult ADHD: methylphenidate and amphetamines. Concerta and Ritalin (either short or long-acting) are methylphenidate, while Adderall and Vyvanse are amphetamine stimulants.
  3. What made Vyvanse stand out was the long-term release. Taken once daily, Vyvanse is released at the same levels over time, which allows for a similar effect 90 minutes to 14 hours after taking it.
  4. Abuse potential. Vyvanse carries a smaller risk of abuse than shorter acting medications like Adderall, Ritalin, or Focalin, due to the longer duration of action. The longer effect of Vyvanse also leads to fewer rebound symptoms throughout the day compared to the shorter-acting ADHD meds.
  5. It doesn’t matter if you take Vyvanse with food or not.
  6. It does matter if you take Vyvanse with acidic meds or supplements. Some examples include vitamin C, aspirin, penicillin, or furosemide, which will all decrease the level of Vyvanse in your bloodstream. The opposite is true if you take Vyvanse with basic drugs like sodium bicarbonate (found in Zegerid or Alka Seltzer), Benadryl, codeine, or metoprolol, which may increase levels of d-amphetamine, the active metabolite of Vyvanse. Your pharmacist can help you with potential interactions.
  7. Most common side effects? The most commonly reported side effects in adults taking Vyvanse are decreased appetite, dry mouth, and insomnia, which occur in 1 in 5 folks taking it.
  8. Will it affect blood pressure and heart rate? Vyvanse leads to an increase in noradrenergic and dopaminergic neurotransmission—sympathetic nervous system effects, which means your “fight or flight response.” While increases in blood pressure and pulse may occur, changes in vital signs are usually small and changes in ECG (heart tracing) are not clinically relevant.
  9. What about driving when taking Vyvanse? In young adults with ADHD, treatment with Vyvanse had a positive effect on reaction time with significantly fewer accidents. Studies show Vyvanse was associated with significantly faster reaction times (91% faster) and lower rate of simulated driving collisions.
  10. Parenting. Interesting studies have been done looking at treatment with Vyvanse when both parent and child (age 5-12) have been diagnosed with ADHD. The parents with ADHD taking Vyvanse showed a significant reduction in “negative talk” and an increase in praise of their children. Results also showed reductions in the ratio of commands to verbalizations—less yelling, more talking.

What has your experience been?

Dr O.

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