Attention deficit hyperactivity disorder (ADHD) is one of the most prevalently diagnosed disorders. An average of 11.3% of children ages 5-17 had or received a diagnosis between 2020 and 2022, according to the Centers for Disease Control. For people with ADHD, finding ways to manage symptoms can be crucial to daily functioning and quality of life. Many turn to medications as part of their treatment plan to boost attention span and focus. For some, this involves taking Vyvanse.
Before you and your doctor decide if Vyvanse is right for you, it can be helpful to understand several aspects of the medication, including what Vyvanse does, its uses, risks, and other pertinent information.
Understanding Vyvanse
Vyvanse is a brand name for “lisdexamfetamine.” It’s a Schedule II, federally controlled substance, meaning you can only obtain it through a monitored prescription.
The medication is absorbed by the GI tract, which converts it into dextroamphetamine. It’s a stimulant medication used commonly for ADHD and occasionally binge eating disorder (BED).
As the body absorbs and processes it, Vyvanse alters norepinephrine and dopamine levels in the brain. While the exact science behind how it works for people with ADHD is currently unknown, scientists do know that it blocks the reuptake of both norepinephrine and dopamine, which increases how much of these chemicals are present in nerve synapses.
For people taking Vyvanse for binge eating, it’s believed that by slowly increasing dopamine and norepinephrine levels in the brain, the impulsivity that often leads to binge eating is controlled. This medication can also cause appetite to decrease, which may further reduce binge eating.
Uses and Benefits
The FDA recommends the use of Vyvanse for the treatment of ADHD and moderate to severe binge eating disorder. It can also be used off-label for conditions such as treatment-resistant depression and narcolepsy. Doctors note it can potentially improve fatigue, sleepiness, wakefulness, and depression. However, many health insurance companies have different coverage policies for off-label use. You may need to confirm that your off-label use of Vyvanse is approved and covered by your health insurance before treatment.
Since 2023, Vyvanse has been available as a generic medication, with several manufacturers producing both capsules and chewable tablets.
Risks and Side Effects
The side effects of Vyvanse can vary widely, but most are usually quite mild. Your doctor will weigh the potential risks and side effects with the potential benefits you may gain before deciding to prescribe this medication to you. These side effects may include:
- Nausea and vomiting
- Constipation
- Abdominal pain or discomfort
- Dry mouth
- Loss of appetite and weight loss
- Headaches
- Dizziness
- Insomnia or trouble sleeping
- Irritability
- Restlessness
- Nervousness
While these side effects usually subside as your body adjusts to the new medication, if they last or worsen, speak to your doctor about them.
More severe side effects may occur and warrant an immediate call to your doctor, including:
- Blurred vision
- Tachycardia
- Hallucinations
- Mood or behavior changes
- Suicidal thoughts or behavior
- Uncontrollable movements, such as twitching or shaking
- Extreme tiredness
- Unexplained, rapid weight loss
- Abnormal thoughts or behavior
Certain side effect warrant an immediate call to emergency services, including:
- Fainting
- Shortness of breath
- Seizures
- Weakness on one side of the body
- Confusion
- Difficulty speaking
- Sudden vision changes
- Pain in the left arm, chest, and jaw
While Vyvanse is largely effective in treating ADHD in patients 6 years and older, it does carry some degree of risk. While rare, these include:
- Cardiovascular reactions, including sudden death, stroke, and myocardial infarction.
- Increase in blood pressure or heart rate.
- Adverse psychiatric reactions, such as psychosis and manic episodes. These may be exacerbated for people with preexisting psychosis or manic symptoms.
- Growth suppression in children ages 6 to 12.
- Serotonin syndrome, a rare but life-threatening condition in which serotonin levels get dangerously high. It’s particularly prevalent when amphetamines are used with other medications that affect serotonin levels, such as monoamine oxidase inhibitors (MAOIs), antidepressants, and selective serotonin reuptake inhibitors (SSRIs).
- Peripheral vasculopathy, a narrowing or blocking of blood vessels.
Precautions and Considerations
Before you start taking Vyvanse, it’s important to be completely transparent about all other medications you take, as well as any adverse reactions you’ve had to previous medications. Your doctor needs a full medical history to determine if you have risk factors that may preclude Vyvanse as a potential treatment option. In particular, be sure to disclose any of the following in your medical history or in your family:
- Blood circulation problems
- Mental health condition
- Heart conditions
- High blood pressure
- Hyperthyroidism
- Glaucoma
- Seizures
- Kidney disease
- Substance use or abuse
- Uncontrolled muscle movements
Once you’ve been prescribed Vyvanse, your doctor will likely recommend that you schedule regular appointments to check on your progress as you adjust. By monitoring progress and symptoms, your doctor can adjust dosage as necessary to help you get the most out of it or determine if the medication doesn’t work for you. Children in particular must have regular monitoring to ensure they continue to grow adequately.
Because this medication can cause dizziness, you should not drive or use heavy machinery until you’ve determined how your body reacts to it. Likewise, you should limit the use of alcohol and marijuana while taking this medication, which can exacerbate dizziness.
This medication can be passed on to the fetus during pregnancy, so caution is necessary if you are pregnant or planning to become pregnant. Your doctor can discuss the risks and benefits with you and determine whether you should take Vyvanse while pregnant. Breastfeeding is not recommended while taking this medication.
People can develop a Vyvanse tolerance with regular use, meaning their body no longer reacts the same way to the dosage. It also has the potential to be addictive or misused. Take this medication exactly as prescribed to minimize the risk.
Dosage and Administration
Vyvanse is typically prescribed either as a capsule or a chewable tablet. Your doctor will dictate the dosage, typically recommending you take it early in the morning to prevent trouble sleeping later. It can be taken with or without food, depending on your preferences.
For best results, your doctor will likely recommend that you take Vyvanse daily at the same time each day. However, they may recommend that you stop taking it for a period of time to see if you still need it.
The exact therapeutic dosage varies from person to person. However, for ADHD management, dosages start at 30 mg once per day in the morning for children six and older and adults. That dosage may slowly be increased until either symptoms improve or you reach a maximum dosage of 70 mg per day. People with BED typically follow the same dosage.
This is just a guideline for treatment and your doctor may opt to prescribe Vyvanse differently for you. Be sure to follow their prescription and don’t alter your dose without their instructions.
Ideally, you should take the capsule or chewable tablet according to instructions. However, if you struggle with swallowing the capsule, a doctor may recommend that you open the capsule and pour the medication into water, yogurt, or juice. Stir it well and take it immediately.
Treatment Duration and Withdrawal
Vyvanse is typically used as a maintenance medication, which requires it to be taken long-term, and in some cases, a lifetime. Your doctor may opt to change your prescription or halt use if it’s not working, or if you exhibit certain side effects. If you’ve taken this medication for a long time prior to quitting, your doctor may recommend slowly tapering off, reducing your dose gradually to minimize withdrawal symptoms.
Unlike many other drugs, there are no medications to ease the symptoms of a withdrawal from Vyvanse. Common symptoms may include:
- Anxiety
- Increased appetite and overeating
- Increased sleepiness
- Difficulty feeling pleasure
- Depression
- Cravings for Vyvanse
While in most cases, withdrawal symptoms tend to fade within a few weeks, they can last several months if you’ve taken high doses of the medication for an extended period of time.
Conclusion
Vyvanse can be an effective way to manage ADHD symptoms long-term, but not without some education about the drug. It’s okay to have some hesitation about whether it’s right for you and to explore your options. Your doctor should be able to answer any questions you might have about the pros and cons of starting, quitting, or remaining on Vyvanse.
