Archive for Adderall XR

ADHD Medication Shortage: What’s The Cause?

As a doctor who treats ADD/ADHD, and an advocate for patients, I am concerned about issues which impact people getting the treatment they need. In fact, it is often so hard for people to get the right diagnosis, and then find the right treatment – including non-medication treatments, that when they find a medication that works – it is imperative that they have the ability to use it…

Right now, there is a real ADHD medication shortage in the USA. It is not really clear to me what the cause of this is. Researching online has led me to some interesting theories.

Blogger/Reporter Jim Edwards from The CBS Interactive Business Network recently wrote an article called: How a “Shortage” of Adderall Actually Increased Sales of the ADHD Drug. In this article, he documents that the sales by Shire of Adderall XR have actually increased during this time frame. I must admit – that as a doctor (and not having ever taken a business course in my life), a lot of this article goes over my head.

But it leaves me with the question: What’s really going on here? There seems to be an issue with the supply of the ingredients from the DEA. There also seem to be disputes between Shire and the companies which manufacture the generic medications (i.e. Teva and Impax). The legal references in the article referenced above don’t help to clarify the issue for me (I’m not a lawyer either…).

I urge all involved to remember this: when you are impacting the supply of patient’s medication for ADHD, you are seriously impacting their lives – for the worse.

I support medication treatment for ADHD, as it works quite well and helps many people. I also support pharma companies profiting from the creation and distribution of medication. If there weren’t profit involved – there would be no innovation, and new treatments would never be developed. I also support win-win situations – i.e. patients get great treatment options, and pharma earns a profit by helping people to get better treatment.

I don’t support when the regulators and/or the companies interfere with the supply of needed treatment. This is NOT win-win.

My hope is that for all of the patients involved – that this can be resolved quickly and efficiently.

Please share your thoughts below.

Best,

Dr. Kenny

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ADHD Medication Shortages: Has This Affected You?

It seems that the shortage of ADHD medication in the USA is lasting much longer than anyone thought it would.

In this article, it is explained that the shortage is related in part to the increased demand for ADHD medication, as well as the DEA controlling the amount of the active ingredient forwarded to the pharma companies to allow them to produce the medication.

It seems that the medications impacted are: Adderall XR, as well as generic Adderall, and generic methylphenidate.

The article referenced above has a quote from the director of the FDA drug shortages program. It’s interesting to me that the FDA has a program for drug shortages. It makes sense… and then the question is – what are they doing about this?

And why is it that it is predominantly the generic medications (which are cheaper and have less profit involved) which are having trouble with supply?

I’m really interested to hear what is happening on the ground out there. Please share your comments and experiences in the comments below:

  • Are you impacted by this shortage?
  • Have you been struggling to get the prescribed medication for yourself or your family member?
  • What have you done about it?
  • Have you had to purchase a much more expensive brand name product?
  • Have you taken less medication to ‘make your prescription last’?

Thanks for sharing your experiences. By sharing here, you can let people know what is happening – without it being ‘filtered’ by mainstream media.

Best,

Dr. Kenny

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Adderall XR: Doses and Duration

Adderall XR has the same composition of Adderall — mixed amphetamine salts. The difference between the two is that the XR version is placed in a 12-hour capsule, half of which is intended for immediate release and the other half for a delayed release.

The doses in which it comes are 5, 10, 15, 20, 25, and 30 mg. This makes it easy to adjust a dose and actually getting you a precise and tailored amount of the drug that will meet your specific needs. The capsules, by the way, can be opened and sprinkled on certain foods, like applesauce, should you or your child not be able to swallow pills.

The exact dosage your physician eventually administers you depends on a variety of factors, including your age, what other ADD/ADHD medications you’ve tried in the past as well as any other medications you’re currently taking for any other conditions.

It’s extremely important therefore that you answer your prescribing doctor honestly about any medication you’re currently using. If you are using something that would provide a bad reaction to the medication or you’re taking another medication itself that may interfere or react with Adderall XR.

The usual dosage for children six years of age to 12 years is 10 mg a day. Some doctors prescribe as much as 30 mg for the day, depending on the age and needs of the child.

For those between 13 to 17 years of age, the dosage starts at 10 mg. Your doctor may work adjust the dosage up as high as 20 mg every day. Adults — both female and male — usually receive 20 mg.

Your doctor will probably put you on the lowest dosage possible initially, and monitor your actions closely. As he sees your reaction on that amount, he’ll adjust the medication as necessary.

Studies Provide Positive Evidence

Several studies, conducted with Adderall XR, demonstrate the long-lasting medication does seem to perform as Shire, the manufacturer, intended it to. One study looked at the behavior of children taking the medication and another group who were not on this medication. Members of both groups suffered from ADD/ADHD.

Teachers noted significant improvements in the behavior patterns of those children who took the medication compared to those who were not taking the medication.

Another, similar study, examined teenagers and the use of Adderall XR. Those individual teens who had taken Adderall XR displayed a greater improvement in their ADHD symptoms compared to those who were not taking it.

But that’s not all. Adderall XR is also effective at the adult level as well.

Dr. Kenny

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Adderall: Dosing and Duration

Mention the phrase “attention deficit hyperactive disorder” and most people immediately associate it with the drug Ritalin. The two words seem to go and and hand with the other.

It might surprise you to know though that in the U.S. Adderall is actually the most commonly prescribed medication for this health disorder. Adderall and its sister medication Adderall XR share nearly 25 percent of the medication market. That means that for every four people taking some type of prescription drug — one of those people is taking a form of Adderall.

Different from several other attention deficit drugs on the market, Adderall is not a single chemical or drug, but a powerful bend of a combination of stimulants. Specifically Adderall is composed of amphetamine and dextroamphetamine.

The medical community believes this prescription drug works through the restoration of the balance of neurotransmitters in the brain, namely dopamine and norepinephrine.

ADD/ADHD isn’t the only health disorder that Adderall benefits, though it’s certainly one of the biggest. This medication is also administered to those individuals who suffer from narcolepsy. This is a condition in which a person suddenly and randomly just falls asleep regardless of the time of day or the activity he is pursuing.

Having said this, Adderall should be not used to treat tiredness or for those who don’t have an actual, diagnosed sleep disorder.

Adderall is taken by mouth upon arising in the morning — or at a time in the morning specifically directed by your physician. If more than one dose is prescribed than you’ll more than likely be instructed to take them about four to six hours apart. That’s the approximate duration of this prescription drug.

This means that you — or your child — will need to take this pill at least two times and probably three times a day. And be careful about a “before bedtime” dose. If you or your child should take these less than six hours before bedtime, sleeping problems may arise.

Be sure to take this medication exactly as prescribed. Your doctor has tailored your dosage to meet your specific medical condition and to your responses to previous therapy. At the outset of using Adderall, you may find that your physician is “fiddling” with your prescription. It may seem like fiddling to you, he’s actually making all the necessary adjustments — fine tuning your dosage you might say — that hopefully will give you precisely the correct amount for your daily needs.

Dr. Kenny

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Generic Adderall XR – New Formulations

Adderall XR went generic in the US in April 2009. I wrote an initial blog post about it here: Generic Adderall XR. You can also review the nature of generic medicines in an article here: Are Generics The Same?.

While my initial thoughts were that the generic Adderall XR was very similar to the trade brand (made by Shire), the comments on my blog post made it clear that many people are finding that the generic version of Adderall XR just doesn’t work as well as it is supposed to.

As DS writes:

“After the first week, I really felt a difference, but tried to put it out of my mind. My shoulder and rib cage is sore, I don’t sleep and I am snapping at people all day, all night. This is not the same drug mixture/compound. It cannot possibly be. I feel tired from the lack of sleep, moody/agressive/weepy (not me!), sore (for no apparent reason) and just plain out of sorts.

Has anyone had any luck figuring out why some of us are feeling this hell-ish effect from the generic version?

- Sleepless (and crabby) in Seattle

The original generic Adderall XR was produced by the pharmaceutical company Teva.

Now, two more pharmaceutical companies will be joining the production of Adderall XR:

  1. Impax Pharmaceuticals will begin to ship its own version of Adderall XR at the end of 2009/early 2010. You can read more about this here.
  2. Sandoz Pharmaceuticals just settled a law suit with Shire (the original makers of Adderall XR) to allow them to make a generic version of Adderall XR as well. It is not clear when their production and distribution will begin. You can read about this here.

Why Are These Generics Coming?

When a pharmaceutical company creates a new medicine, they get a patent for a certain number of years. They spend hundreds of millions of dollars to get their drug to market, and then they have a number of years to profit from their medicine, before it goes ‘generic’ and other pharmaceutical companies start to manufacture the medicine (and they sell it for less).

Even when a medicine is within its patent, the generic pharmaceutical companies start law suits to challenge the patents – i.e. to see if they can start to market the drug earlier, and increase their profits. It seems that the companies that are now manufacturing and selling generic Adderall XR have pursued the legal process to challenge Shire’s patent, and they are now in the position to start to manufacture and profit from this medicine.

What does this mean to you?

Well, although I initially thought that the generic Adderall XR wouldn’t cause problems for people – there are 94 comments on my original blog post which essentially prove me wrong – i.e. many people are struggling with the generic form of the medicine.

Here is where it gets complicated.

If you used to be on the Shire Adderall XR, and then the Teva generic comes out – your pharmacy or insurance gives you the ‘cheaper’ version. Let’s say it doesn’t work as well for you, but because of the finances, or your insurance’s policy, you work with your doctor, adjust the dose and make it work.

Now, your pharmacy, or insurance company may make a deal with Impax – to get their new version of generic Adderall XR. Now, the formulation is slightly different again. Translation – you may have a different response or reaction to the new version of the generic than you did to the first one. You’ll need to go to your doctor, advocate at your insurance, and see if you can get on the medicine which works best for you.

Of course, if you can afford it – you can always ask your doctor for a prescription for Adderall XR – No Substitution (this means that your doctor is insisting that you get the original adderall xr only). The thing is that your insurance can refuse to pay for it, even if your doctor is that specific.

This can be complicated for you, or your child if you take Adderall XR. Best to monitor your symptoms, and work with your doctor to find the best solution for you.

Please share your thoughts and comments below. Your input is tremendously helpful to thousands of other people who come to this blog and learn from your experience.

All the best,

Dr. Kenny

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Generic Adderall XR in the US

As of April 3, 2009, generic Adderall XR is available in the United States. It is being made by Teva Pharmaceuticals. (You can review a news report about this here.)

What Does ‘Generic’ Mean?

When a medicine is first released – it is patented by the company that invested in the research to develop it. They have a certain number of years to market the medicine exclusively. After the patent runs out – the medicine can be created by other drug manufacturers – the ‘generic’ companies – generally at a significant discount.

The analogy here is ‘Kleenex’ vs. tissue.

Kleenex is a brand of tissue. It is only made by one company. However, tissue is made by many companies.
Using this analogy – Adderall XR is the ‘Kleenex’, and generic adderall XR is the ’tissue’.

Will it work the same?

The short answer is yes. Generic drug manufacturers are able to have a minor variation in how much of the medicine will be absorbed, but for most people, this will not have an impact. In my clinical experience, a small percentage of people are sensitive to the differences and may need to have the ‘brand name’ medicine only. If that is the case, the doctor needs to write a prescription for Adderall XR NO SUBSTITUTION. When the words ‘no substitution’ are there, it tells the pharmacist that only the original Adderall XR will do.

For further information on generic medicines in ADHD, please visit this article that I’ve written previously on this topic.

What Does This Mean for You?

If you have wanted to take a newer, long acting medication like Adderall XR – it just got cheaper.
If you have insurance to pay for your medication, then this is unlikely to matter much to you. If you have to pay for your medication yourself, then it may make a difference to you.
Please remember – this news just applies to the US, as Adderall XR has not gone generic in other countries – such as Canada.

Does this impact you? Share your thoughts and comments below.

Best,

Dr. Kenny

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Concerta and Adderall Covered in Ontario

I’m pleased to inform you that as of April 1, 2009, Concerta and Adderall XR will be covered under the Ontario Drug Benefit (ODB) program.

This is a huge improvement for people who were previously not able to get coverage for these newer medications.

Who is covered under the ODB?

The Ontario Drug Benefit Program covers people who are on: Ontario Works, Ontario Disability Support Program, Assistance for Children with Severe Disabilities, or the Trillium Drug Plan.
(and if you are an Ontario family who doesn’t have insurance, please take a moment and look into the Trillium Drug Plan – if you qualify – it could get you insurance coverage).

In the past – the Ontario Drug Benefit would only cover the following medications for ADHD: immediate release methylphenidate (ritalin), Ritalin SR, and Dexedrine. The Dexedrine Spansules (the longer acting Dexedrine) were available via special application. It was generally not hard for doctors to get approval for their patients with the Dexedrine Spansules.

When the newer medications became available – i.e. Adderall XR, Biphentin, Concerta, and Strattera (listed alphabetically), they were all gradually added to the ‘Individual Clinical Review’ Process. This meant that the doctor could apply for any individual patient to get coverage. To qualify for this coverage, the patient had to have tried a methylphenidate medicine (i.e. Ritalin or Ritalin SR) and have failed it, AND he/she had to have taken Dexedrine and failed it, AND he/she had to take the newer medicine for at least 30 days (without funding) and it had to have worked well.

Even when doctors would go through this process and apply for coverage, patients were often refused coverage. This was frustrating for the patients, as well as for the doctors, and it left families without insurance coverage for the medicine that was working best for them.

I’m pleased that there has been a change in the Ontario Drug Benefit Program. As of April 1st 2009, Concerta and Adderall XR will be covered on the ODB. Unfortunately, this new coverage does not include Biphentin and Strattera. This is unfortunate, and hopefully the new coverage can be extended into the future. (Strattera and Biphentin can still be applied for through the Individual Clinical Review process).

The short message for the getting coverage for Concerta and Adderall XR is this: There is no additional paperwork needed. I will reproduce the official criteria below – so please feel free to share this information with your doctor.

The official documentation can be found here (as a PDF document – the relevant pages are pages 2 and 3).

Notes: Patients > 6 years of age diagnosed with ADHD according to DSM-IV criteria and where symptoms are not due to
other medical conditions which affect concentration, and who require 12-hour continuous coverage due to academic and/or
psychosocial needs, and who meet the following:
1) Patients who demonstrate significant and problematic disruptive behaviour or who have problems with
inattention that interfere with learning; AND
2) Prescribed by or in consultation with a specialist in pediatric psychiatry, pediatrics or a general practitioner
with expertise in ADHD; AND
3) Have been tried on methylphenidate immediate release (IR) or methylphenidate slow release (SR) or
Dexedrine IR or Dexedrine SR (Spansules), and have experienced unsatisfactory results due to poor
symptom control, side effects, administrative barriers, or societal barriers.
Administrative barriers include:
. inability of a school to dose the child at lunch;
. the school lunch hour does not coincide with the dosing schedule;
. poor compliance with noon or afternoon doses;
. the patient is unable to swallow tablets.
Societal barriers include:
. the patient or patient’s caregiver(s) has(have) a history of substance abuse or diversion of listed
immediate-release alternatives;
. the patient or patient’s caregiver(s) is/are at risk of substance abuse or diversion of listed
immediate-release alternatives.

The coverage is for the following doses of Concerta:

  • Concerta 18 mg
  • Concerta 27 mg
  • Concerta 36 mg
  • Concerta 54 mg

The coverage includes the following doses of Adderall XR:

  • Adderall XR 5 mg
  • Adderall XR 10 mg
  • Adderall XR 15 mg
  • Adderall XR 20 mg
  • Adderall XR 25 mg
  • Adderall XR 30 mg

This decision is a great step in the right direction to get the most effective medicines into the hands of people who need them. While I’m happy for Ontarians, I am also concerned that many other provinces do not have the insurance coverage that is needed. Also – we want to extend this coverage to Strattera and Biphentin.

I want to acknowledge the significant advocacy work done by CADDAC – the Centre for ADD/ADHD Advocacy Canada. This organization has been working diligently on this issue – and played a critical role. I suggest you visit their site and get involved.

Does this decision impact you or your family?

Do you live outside of Ontario, and have your own thoughts and opinions on insurance coverage – for the newer vs. the older medicines? Please shrae your comments below.

Best,

Dr. Kenny

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Vyvanse Dosage: How to Get the Right Dose

Vyvanse is the newest medicine for ADD or ADHD in the USA. I have written several articles on this blog on Vyvanse, and have had great feedback and comments from readers of this blog. For example – if you want to find out if vyvanse works, visit this post to read many people’s first hand experiences.
One question which many people ask is about the dosing of Vyvanse.
This article will provide you with the answers you need to get the right dosage of Vyvanse.

Research studies compared the dosing of Vyvanse with Adderall XR. What this research showed was the following:

  • Vyvanse 30 mg = Adderall XR 10 mg
  • Vyvanse 50 mg = Adderall XR 20 mg
  • Vyvanse 70 mg = Adderall XR 30 mg

The recommendations for the starting doses of Vyvanse are as follows: Doctors should start Vyvanse at 30 mg, and then gradually increase the dose to 50 mg, and then up to 70 mg if needed. Of course the doctor would monitor response to the medicine (i.e. if there is a great response and ADHD is controlled at 50 mg, then there is no need for 70 mg of Vyvanse). The doctor will also monitor for side effects – i.e. if there are too many side effects at 70 mg, then the dose may need to be dropped to 50 mg of Vyvanse.

The importance of the ‘conversion’ dosing listed above relates to those people who may switch from one stimulant medicine to Vyvanse. Using the information above, you can figure out how to change your dose of Adderall XR to Vyvanse.

When it comes to the available strenghts of Vyvanse, Vyvanse is now available in the US in the following dosage strengths:

  • 20 mg
  • 30 mg
  • 40 mg
  • 50 mg
  • 60 mg
  • 70 mg

In Canada, all of the dosage strenghts are available except for the 70 mg dose. The dosage recommendations above are the general recommendations for dosage. That said, your doctor may start lower, and may take a different approach to your dosing. When Vyvanse was first release, there were fewer strengths of the medicine available – i.e. only 30mg, 50 mg and 70 mg. Now, there are the ‘in between’ doses as well (the 20 mg, 40 mg, 60 mg). This does give doctors more flexibility in adjusting the dose to tailor it to suit you.

If you are switching from Concerta to Vyvanse, then you will need to follow these rough guidelines (and of course, talk to your doctor – who can personalize the information to suit your treatment):

  • Concerta 36 mg = approx. Vyvanse 30 mg
  • Concerta 72 mg = approx. Vyvanse 50 mg

I have to say that the dose changes from Concerta to Vyvanse are based on logic, and not on research.
Here is the logic:

  1. Concerta 36 mg works out to approx. 8 mg of regular ritalin three times daily.
  2. That is approximately 5 mg of regular adderall twice daily.
  3. That works out to approximately Adderall XR 10 mg once daily.
  4. Since Adderall XR 10 mg daily is equal to Vyvanse 30 mg, once can guess that Concerta 36 is equal to approximately Vyvanse 30 mg.

[Click here for a full review of how to calculate concerta doses.]

There are two important points to remember here:

  1. Even though I can suggest what the equal doses are, you may react differently to any one medicine. Only testing, monitoring and talking to your doctor will help to sort out what the right dose is for you.
  2. Please talk to your doctor about your individual care. Even though this blog article may help you to find the right dose of Vyvanse based on a combination of my review of the research and my opinion, your doctor is an expert in your care.

Thank you for reading, and please post any comments or your experiences with the dosing of Vyvanse in the comments below.

Dr. Kenny

(Updated May 2010)

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Vyvanse – The New Medicine for ADD/ADHD

What is Vyvanse?

[Article Updated May 2010]

Vyvanse is a new ADD/ADHD drug manufactured by Shire that was approved by the FDA in February 2007 to treat ADD/ADHD symptoms in children aged 6 through 12. It is a prodrug, which means that it must be orally ingested to activate its main ingredient, lisdexamfetamine dimesylate. So the actual medication is inert – i.e. it doesn’t do anything – until an enzyme in the body converts the medicine into the active drug. Because Vyvanse is a stimulant which is not a functioning stimulant (until it is converted by an enzyme in the body), it has a much lower abuse potential than other ADHD stimulant medicines.

When Vyvanse enters the stomach and small bowel, there are enzymes which will break the medicine up. Vyvanse will become: lysine (an amino acid that has no impact on ADHD), as well as dextroamphetamine. Dextroamephetamine is a medical amphetamine (different than the ‘street drugs’) which is very helpful for ADHD. It has been used for treatment of ADHD for decades, and has been available under different names like: Dexedrine and Dextrostat. Once the active medicine is broken from the amino acid lysine, it can now begin to function to help ADHD.

Thus, if someone tries to abuse Vyvanse by snorting it, or even trying to inject it – they will not get a high because it will not be an active medicine until an enzyme in the body works on it and ‘activates’ it.

Although it is generally thought that the medicine is mainly broken down or ‘activated’ in the stomach/small bowel, it may also be ‘activated’ in the blood as well.

In clinical studies, parents reported that their children’s ADD/ADHD symptoms were consistently controlled throughout the day, even through homework time from 4 P.M. to 6 P.M. Newer research is showing that Vyvanse can work for 13 hours and maybe even longer. Additionally, children taking Vyvanse in the study were able to focus and perform better on tests; in a timed math test, a group taking Vyvanse attempted 51% more math problems than the group given placebo, and provided correct answers 54% more often than the placebo group.

An overall improvement was recorded in 95% of children that took Vyvanse for 12 months.

What are the characteristics of Vyvanse?

Vyvanse is in the same medication family as Adderall; its active ingredient is lisdexamfetamine dimesylate. It provides consistent ADD/ADHD symptom control for 13 hours. Vyvanse is a capsule that can be swallowed whole or the capsule can be opened and mixed with water (for kids who can’t swallow).

Vyvanse is taken once daily and is available in six dosage strengths (when it was first launched in the US, it was only available in three strengths, but there are more options now):

  • 20 mg
  • 30 mg
  • 40 mg
  • 50 mg
  • 60 mg
  • 70 mg

These different strengths give you and your doctor some flexibility in determining which dosage is right for you, your teen or your child. The recommended starting dose for Vyvanse is 30 mg once per day taken orally in the morning. The dosage may then be increased by up to 20 mg per day at weekly intervals, up to a maximum of 70 mg per day.

Who is Vyvanse approved for?

Currently, Vyvanse is approved for children aged 6 to 12 years, as well as adults aged 18-65 years old.

While there is not yet official approval for Vyvanse in Adolescent ADHD, many doctors are using this medicine for teens, and presumably the official indication will be coming soon.

What are the side effects of Vyvanse?

Vyvanse was very well tolerated in clinical studies with children. The most common side effects were decreased appetite, difficulty falling asleep, irritability, and stomachache. Generally, the side effects were described as mild to moderate; occurrence and severity of side effects decreased over time. As with any prescription medication, it is important to remember that your doctor has prescribed it because he/she feels that the benefits will outweigh the possibility of side effects.

How much does Vyvanse cost?

Vyvanse will cost the same as Shire’s other popular ADD/ADHD drug, Adderall XR: around $3.40 a day. The cost may even be less than Adderall XR because it is estimated that patients who switch from Adderall XR to Vyvanse might need fewer doses.
Ritalin remains the cheapest ADD/ADHD drug; Vyvanse costs considerably more than Ritalin and Ritalin SR. The cost is comparable to the 36mg and 54 mg doses of Concerta, which is around $140 per month.

When can Vyvanse be used?

Vyvanse should be taken once daily in the morning. It provides consistent ADHD symptom control throughout the day for up to 13 hours. In clinical studies, parents reported that their children’s ADD/ADHD symptoms were controlled at approximately 10 A.M., 2 P.M., and 6 P.M., and demonstrated consistent symptom control throughout the day.

Vyvanse is a once-a-day capsule that should be taken in the morning, either with or without food as prescribed by your child’s doctor. If your child is unable or unwilling to swallow pills, Vyvanse capsules may be opened and the entire contents of the pill can be dissolved in water. The entire portion must be finished and should not be stored for later use.

New research is demonstrating that Vyvanse’s absorption and effectiveness is completely unaffected by stomach factors. So – whether Vyvanse is taken with or without food, whether someone is taking antacid medicines, or has a GI disorder (like Celiac’s for example) – it will NOT have an impact on the effectiveness and delivery of vyvanse in the body. This is different than the other medicines for ADHD – like Adderall XR and Concerta, for example.

Can Vyvanse be abused?

The abuse potential of Vyvanse is extremely low; the medication is designed to have a reduced or minimal abuse potential. Since Vyvanse requires oral ingestion to be converted to the active drug, the capsule contents are highly unlikely to be sought out for inhalation or injection.

How does Vyvanse compare to Ritalin, Ritalin SR, and Concerta?

Vyvanse is a new class of ADD/ADHD medication. It is the only medicine which is a pro-drug for ADHD.

Unlike Ritalin, Vyvanse is not an immediate release stimulant. Vyvanse has much lower abuse and addiction potential. Ritalin SR and Concerta are long-acting formulations like Vyvanse, but Vyvanse has been shown to provide more consistent symptom control over a longer period of time than Ritalin SR and Concerta.

Ritalin, or methylphenidate, must be taken two or three times a day for symptom control, whereas Vyvanse is only taken once. The effectiveness of Ritalin is often inconsistent. It is inexpensive, but abuse and addiction potential is much higher with Ritalin than with Vyvanse.

Ritalin SR is a long-acting formulation of methylphenidate with inconsistent performance reviews. It doesn’t work for everyone and usually lasts up to 6 hours. However, like short acting Ritalin, Ritalin SR is inexpensive.

Of the three, Concerta is the most comparable ADD/ADHD medication to Vyvanse. They both control symptoms for up to 12 hours and are generally well-tolerated. Concerta is not a prodrug, so the abuse potential is theoretically higher than it is for Vyvanse.

Where is Vyvanse Available?

At the time of this article update (May 2010), Vyvanse is only available in the USA and Canada. It is not yet available in other parts of the world. Please check back, as I will update this article when Vyvanse will be available in other countries such as: the UK, Australia, Europe, etc.

New Data On Duration of Action of Vyvanse in Adults with ADD/ADHD:

New research has shown that Vyvanse works in adults with ADD/ADHD for up to 14 hours. This is a real benefit for Vyvanse, as adults have many responsibilities throughout the day and into the evening. This suggests that many people can avoid taking a short acting stimulant in the early evening (i.e. Taking Adderall XR in the morning, and short acting Adderall in the late afternoon to make the medicine last), by just taking Vyvanse which will last long enough to cover the symptoms throughout the day and the early evening.

The Bottom Line About Vyvanse

Treatment and management of ADD/ADHD requires many components; this article focuses only medication. Vyvanse is a breakthrough ADD/ADHD drug and many doctors and parents will seriously consider switching from their current ADD/ADHD medication for the benefits Vyvanse offers: low abuse and addiction potential, one daily dose, and symptom control for up to 13 hours. For more information on the other treatments of ADD/ADHD: 1) sign up for my ADD/ADHD newsletter at www.TheADHDDoctor.com, and 2) peruse this blog for more articles about ADD/ADHD.

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