Vyvanse (Lisdexamfetamine)

By Ioana Cozma

Last updated: 21 March 2024 & medically reviewed by Dr. Kimberly Langdon

What is Vyvanse?

Vyvanse is the brand name for lisdexamfetamine, a stimulant used for treating attention deficit hyperactivity disorder (ADHD) and binge-eating disorder (BED) in individuals above six. While the precise treatment mechanism is not fully understood, stimulants such as Vyvanse may increase synaptic catecholamine concentrations, thus increasing the production and function of noradrenaline and dopamine in the central nervous system.^[1][2][3]

The results are improved focus, attention, and impulse control.

Vyvanse is a long-acting medication that provides sustained symptom relief throughout the day due to its gradual and prolonged metabolization. This extended duration of action is associated with consistent symptom management with minimal sudden peaks and crashes typically associated with shorter-acting stimulants.^[4]

Vyvanse dosage

The recommended Vyvanse dosage for patients aged six and above is 30 mg once per day in the morning. If the dosage is insufficient, the healthcare provider may increase it by 10 to 20 mg per week, with a maximum dose of 70 mg/day. The maximum dosage for patients with renal impairment is 50 mg/day.^[2]

General recommendations for Vyvanse treatment include taking Vyvanse VS orally in the morning, with or without meals. The Food & Drug Administration (FDA) advises patients to avoid afternoon doses that may cause insomnia. A thorough pre-screening is also advised, as healthcare professionals should evaluate the presence of cardiac disease and the risk of drug abuse.^[2]

People who have taken monoamine oxidase inhibitor (MAOI) antidepressants during the past 14 days or have experienced allergic reactions to stimulant drugs may not be able to take Vyvanse.^[5]

How is Vyvanse abused?

Vyvanse abuse typically involves taking higher doses or using the medicine differently than the healthcare professional prescribes. Vyvanse abuse is recognized by impaired control in using the substance, compulsive behavior, craving, and continued use regardless of negative effects.^[2]

Seeking multiple prescriptions from different doctors, neglecting responsibilities and relationships due to Vyvanse use, and experiencing withdrawal symptoms when attempting to stop using Vyvanse are other signs of Vyvanse abuse.

Taking larger doses may be done to enhance the drug’s stimulant effect, for purposes such as enhanced mental focus, improved mood, or accelerated weight loss.^[6] Most Vyvanse abuse cases occur in individuals between 18 and 25, with the misuse of stimulants becoming a severe issue on college campuses in the United States and abroad. However, Vyvanse abuse has increased by approximately 67% in the general population.^[3]

Vyvanse may also be taken in other forms than the oral recommendation to enhance its stimulant effects. Some individuals may crush Vyvanse tablets into a powder and inhale it, bypassing the intended slow-release mechanism.^[2]

Additionally, Vyvanse may be abused with other substances, such as alcohol or other drugs, to enhance its effects or counteract unwanted side effects.

In rare cases, individuals may dissolve Vyvanse in liquid and inject it intravenously. This method of abuse may lead to serious health complications, including infections and the transmission of bloodborne diseases.

Side effects of Vyvanse abuse

The FDA highlights specific side effects of Vyvanse abuse, such as enhanced heart rate, accelerated breathing, increased blood pressure, and dilated pupils. Individuals taking high or frequent doses of Vyvanse may also experience excessive sweating, uncontrolled hyperactivity, tremors, loss of coordination, and gastrointestinal issues. Mental health symptoms may include aggression, anxiety, psychosis, as well as suicidal and homicidal ideation.^[2][7]

Other studies classify the side effects of Vyvanse abuse in a four-phase sequence, each with distinct side effects. The first phase of stimulant use is described through increased euphoria, while the bingeing phase is characterized by mood swings.^[7]

In the withdrawal phase, side effects result from a crash in the excessive dopaminergic activity caused by Vyvanse. Individuals may experience dysphoria, anxiety, agitation, increased cravings, fatigue, depression, low energy, and repetitive cycles of bingeing and crashing.^[7]

Additionally, people with chronic stimulant use might develop heightened tolerance to its effects, thus requiring increased doses. Common side effects include gastrointestinal issues and cardiotoxicity.^[7]

The FDA also outlines specific safety concerns from prolonged Vyvanse use. These may include severe heart problems or defects and psychiatric events, such as heightened aggressivity, hallucinations, mania, and psychosis.^[1]

Is Vyvanse addictive?

Vyvanse VS has a high potential of becoming addictive because it creates euphoria, mental focus, and motivation, reinforcing the desire to continue using the medication.^[7][8]

The diminishing pleasurable effects of Vyvanse associated with long-term use may determine some individuals to continue seeking the initial euphoric feeling. Therefore, users take Vyvanse more frequently or in larger doses, increasing the risk of addiction.^[7][8]

With prolonged use, the body can develop tolerance to Vyvanse. Therefore, individuals may need higher doses to achieve the desired effects.^[7][8]

Vyvanse vs. Adderall

Vyvanse and Adderall are central nervous system stimulants used for treating ADHD, but Adderall is made of amphetamine salts.^[9] The two medicine have distinct immediate and long-term effects, as well as different dosages.

Vyvanse vs. Ritalin

Both Ritalin and Vyvanse contain distinct stimulant substances used for treating ADHD. Ritalin contains methylphenidate, whereas the primary substance in Vyvanse is lisdexamfetamine.^[10]

Vyvanse vs. Concerta

Like Ritalin, Concerta is a different brand name using methylphenidate, but the drug is also used as an ADHD treatment.

Treatment for Vyvanse addiction

The first stage of Vyvanse addiction treatment may entail detoxification under medical supervision to manage withdrawal symptoms.

Various behavioral therapies may be effective after detoxification, helping individuals modify unhealthy thoughts, behaviors, and patterns associated with drug use. Cognitive-Behavioral Therapy (CBT) and one-on-one counseling are prevalent approaches.^[11]

Support groups may also be effective, as they offer connections with peers experiencing similar addictions. Sharing stories, challenges, and successes in a supportive environment may provide encouragement and a sense of community.

If an individual has co-occurring mental health disorders alongside Vyvanse addiction, such as depression or anxiety, integrated dual diagnosis treatment may be required to address both conditions simultaneously and, therefore, improve recovery chances.