Vyvanse Approved For Adults With ADD/ADHD

On April 24, 2008, the US Food and Drug Administration approved Lisdexamfetamine – known as Vyvanse – to be used for adult ADD and ADHD. Prior to this announcement, the medicine was just approved for use in children aged 6-12.

Although people often think of Attention Deficit Hyperactivity Disorder as just a disorder of childhood – it often carries on into adult life – and studies have shown that over 4% of US adults have ADD or ADHD.

Despite the fact that Vyvanse has just received approval for use in adults – it has been used by some doctors previously, through ‘off label usage’ (see my previous article on this: Vyvanse in Adults).

The study which led to the approval included 414 adults, aged 18-55 years old. Over 4 weeks, they were tried on Vyvanse or placebo. Generally, the adults noted significant improvement within 1 week of starting the medicine. All doses used (i.e. 30 mg, 50 mg and 70 mg) were all found to be helpful.

The most common side effects experienced by the adults in the study with Vyvanse were: decreased appetite, difficulty falling asleep, and dry mouth.

To read more details about the study, please click here.

Does this mean that you should try Vyvanse if you are an adult with ADD or ADHD?

Not necessarily…
It just means that this is a good treatment option, and that the research has now been done to prove that it is effective for use in adults with ADD and ADHD.
It is best to talk to your doctor about your medication (and non-medication) treatment options.

As I have previously mentioned, as a doctor working in Canada, I have not been able to prescribe Vyvanse, because it has not yet come to Canada.
So, I have asked readers of this blog if Vyvanse works. To read over 275 responses, click here: Does Vyvanse Work?

Other Vyvanse articles on my blog:
Vyvanse Overview
Vyvanse Dose
No Addiction with Vyvanse

Please leave your thoughts or comments below.

Dr. Kenny

[tags] Vyvanse, ADD, ADHD [/tags]

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Comments

  1. My question is -is 4 weeks really long enough to test the full effect of a drug-good or bad?
    Is this the usual trial time for a new medication?
    brenda

  2. This is great news especially since I’ve already got a number of patients taking Vyvanse. The apparent general protocol in our area is to prescribe Adderall or Concerta first. I think this has to do with the familiarity with these medications. Regardless, I’ve heard outstanding reports from children, adolescents and adults who are prescribed Vyvanse. A significant perk is the absence of mood swings that some adolescents report with Adderall. I also hear positive reviews from it’s longer lasting effects in adolescents and adults.

    Rudy Rodriguez, LCSW
    Asheville, NC

  3. This is a big relief! Now we just need the research done to validate more appropriate dosing guidelines for adults! Currently, there are 11adult clients taking Vyvanse in my practice. (There are about 12 more whose doctors/ wouldn’t prescribe, or insurance wouldn’t approve, Vyvanse until it was approved for adults or wouldn’t titrate past 70mg.) Of those adults in my practice currently taking Vyvanse, 1 is therapeutic at about 60 mg. a 2nd at 70 mg. and all of the rest have found their therapeutic doses to be over the pediatric limit of 70 mg. The dosing range for the 9 remaining clients of mine taking Vyvanse is 100 mg. to 250.mg. Every one of these clients has found symptomatic relief, previously unknown to them, with the least side effects. All have previous experience with several other stimulants. Most were previously satisfied with Adderall but state they experience far greater relief, for a longer period, without the side effects, with Vyvanse. It seems that pediatric dosing for adults, who weigh at least twice as much as most children, will most likely produce pediatric results. Vyvanse has a maximum dose two and a half times greater than the other stimulants. It’s a simple math problem. If an adult is therapeutic on Vyvanse at 70mg. that’s great! However, for those who aren’t, the pediatric guidelines serve as an obstacle to appropriate comprehensive treatment and are a disservice to the adult add community. I have one client who met with significant symptomatic relief for the 1st time in his 62 years on Vyvanse 140mg… He had one great week at that dose. Then the insurance company refused to honor the doctor’s prescription. My client had to go back to his previous dose of Adderall because 70mg. of Vyvanse left him too under treated. One week later, this client was fired. His boss had seen the improvement (not knowing it was medication related) and when the return to Adderall resulted in this client’s chronic lateness returning, he was fired. The boss’s rationale was that this client could be on time, (as proven the week before on Vyvanse), so he should be on time. The rationale of the insurance company was that Vyvanse wasn’t approved for adults. This client will try again with the FDA approval but I fear the insurance company will simply point to Shire’s dosing guidelines and refuse payment for any prescription over 70 mg. This week’s approval of Vyvanse for adults is a step in the right direction, but not everyone can breathe a sigh of relief just yet!

  4. I’ve been taking Vyvanse for four months. Began with the dose prescribed for my child which was 50 mg. That was too high for me. I had the experience of “speeding” which made me very productive, but somewhat disengaged from my feelings. I also lost my appetite to the degree that I was concerned that my body wasn’t getting enough nourishment. I have dropped down to 30 mg. Can tell when the meds wear off in the afternoon. I am much less productive then, but like the connection to my usual lethargic self!
    Adderall XR made my heart race, Welbutrin made me anxious and slightly more extroverted than I really am. Vyvanse gives me a positive outlook in the morning and helps me get through routine chores. I don’t feel that I have a personality change. THe dry mouth is slight compared to that experienced with Welbutrin. No trouble getting to sleep. I feel focused but am not overfocused.

  5. First, Dr. Handelman, thank you for the update.

    Regina, that’s a hideous story.

    Anyone else willing to take a bet that that trend will get worse directly proportionate to the general worsening of the economy?

    (Slightly tangential — in this context, is it “proportionate” or “proportional”?)

    So do the prominent doctors and practitioners who read and post here have any specific concrete suggestions for clients/patients who are on the verge of finding help but anticipate hitting this wall – with its labyrinthine bureaucratic mazes leading to roadblocks and prospective massive amounts of paperwork – and falling further through the cracks?

    Or will there be more shrugging and exhortations of “That’s life” and “You can’t win them all”, and behaving as though these people/clients/patients don’t exist and don’t need help NOW – and not ten years from now after yet more “sufficient” blind trials have been conducted to make some sort of tentative hypothesis so that MAYBE insurance companies and doctors will be willing to REVIEW what the clients/patients have to say after all 10 proper requests have been submitted, all in quadruplicate?

    Notwithstanding that these clients’/patients’ actual lives – like that 62 year old guy above, who is probably, at this point, not in the most robust of leveraged bargaining positions in the current job market – have quietly imploded in the meantime?

  6. Vyvanse Approved For Adults With ADD/ADHD

    On April 24, 2008, the US Food and Drug Administration approved Lisdexamfetamine – known as Vyvanse – to be used for adult ADD and ADHD. Prior to this announcement, the medicine was just approved for use in children aged 6-12.

  7. I don’t know if this is the right place to put this post so if it isn’t please move it to the right place.

    I am 32 years old 22 years ago when I was 10 I had been diagnosed with ADD and started on Ritalin. My parents kept me on Ritalin for a couple of months and decided it was just a phase and I was past it. While in high school I was diagnosed with a learning disability something to the effect of anxiety brought about by exams or some such thing. The school diagnostician came to this conclusion because I had an above average IQ, However I didn’t participate in much class, but I was able to answer any question when called upon, and then would do very poorly on the exam. I have tried several times to go to college since high school and usually get about halfway through a semester and drop out. Well over the last 14 years I have hopped from job to job when ever I got bored, restless, or just didn’t feel like going to work. The exception being my current job I’ve been here almost 6 years; not that I haven’t tried to leave but every time I try I get offered different position which has kept me here. I did the same thing in my personal life stick around in a relationship till I got bored or found someone else more interesting or attractive and moved on with the exception of my now wife we were off and on again for the first couple of years but have been together for going on 6 years straight now and have been married for 3 almost 4 years now (not for lack of trying to leave but because she has a way of making me see how stupid I act at those times). About 6 weeks ago I was talking with a good friend (who is also a psychologist) and he asked me a couple of questions about how I felt, things I had done and why I did them, remarked on some of my behaviors he had noticed and suggested that I talk to my doctor about the possibility that I might have ADD. Well with out much effort I was able to blow that off for a week or two and I researched little online about it and read posts on various blogs and it was like reading a journal of my life. So I got an appointment with my doctor he asked me a few questions about my medical history and a few about what was going on and wrote me a prescription for Adderall. I took it twice a day for a month and it almost instantly changed my life. I had spent the majority of my life wondering why I couldn’t seem to finish anything I started and a lot of times couldn’t even start cause the whole thing seemed overwhelming or “Why start it I won’t finish it anyway at least this way I won’t feel the guilt of not finishing yet another task”. I saw all of my friends out at social gatherings and events having fun and enjoying life while all I was able to do was literally sit in a corner and try to block out everything around me. It was like everything was a blur, too much going on to process and it made me feel like I was going crazy. I couldn’t even carry on a conversation without thinking whats going on behind me what are the people two tables over talking about and never being able to focus on my friends and family and enjoy the moment because of the anxiety I felt from everything going on around me was overwhelming. In my mid 20′s I had been diagnosed with Social Anxiety Disorder, and I fit the mold almost exactly. I was given a prescription for Xanax and Paxil. I took the Paxil for about a month with no positive effect whatsoever but I kept taking the Xanax at the start of any anxious feelings. All it did was make me sleepy and lethargic it didn’t really make me feel better but it was better than nothing. Since I started taking medication to treat my ADD. It’s like the fog has lifted I can go out concerts and party’s with no anxiety, at work I don’t feel the sudden urgent need to get up from my desk and go for a walk or go smoke a cigarette. I used to get up and go outside to smoke just because I was bored not that I had a craving or wanted one. Last week I met with my doctor for a one month check up I told him some of the side affects from the Adderall I was constantly chewing, I had no appetite (I had to force myself to eat so I didn’t get sick), dry mouth, lite headaches and some small bowel trouble. He wanted to try me out on Vyvanse. He said it’s more expensive but people who have switched to it from Adderall have reported fewer side effects and some none at all. Luckily my Health Insurance covers Vyvanse it costs $40 a month as opposed to the $4 a month of Adderall but so far so good it’s only been a week I still have dry mouth but thats not something a little water can’t fix and I still eat even though I don’t feel hungry. With all the changes in the last month I find myself wondering how different my life would have been, How much farther down the road and ahead of the game I would be if I had never been taken off the medication as a child or even at the very least Googled what feelings I was having and the problems I was experiencing and found others that felt the same way,but the past cannot be changed what’s done is done and all we can do is move ahead from the point we are at now. I have a 2 year old son who apart from my wife is the most important person in my life. I look at him and see myself not just the physical resemblance but mannerisms and personality and wonder if he too is a victim of the curse that has plagued me my whole life, However I take great comfort in knowing that if he does, the path his life takes will not mirror my own, because I will make sure he has the tools to be the best he can.

  8. Aaron,
    Thank you so much for sharing your story. I’m really glad that you have found some help and that it is improving your quality of life.
    Medication is one step for adult ADHD/ADD, but there are many more.
    I suggest you look into Sari Solden’s book: Journeys Through Adulthood. It is a great book which talks about the process of accepting ADD, and coming to terms with the impact that it can have in your life.
    http://www.amazon.com/gp/redirect.html?ie=UTF8&location=http%3A%2F%2Fwww.amazon.com%2FJourneys-Through-ADDulthood-Discover-Attention%2Fdp%2F0802776795%3Fie%3DUTF8%26s%3Dbooks%26qid%3D1211640314%26sr%3D8-2&tag=adhdtelesemin-20&linkCode=ur2&camp=1789&creative=9325
    (sorry – long link!)
    I hope that other people will find your post helpful.
    All the best,
    Dr. Kenny

  9. My 10 year old is being placed on this after 5 years of being on Adderall Xr. She took 40mg daily. It is not working effectivley. ( still looses attention, and focus, moody, NO appetite!) Her Dr ask i try this becasue her growth curve has plumeted from day one- straight down in weight. She is in 8%. I wanted to know if this is in fact a better/ safer choice? I hear both extremes and worry for her health. I pray i will find the best choice but am always nervous for her.

  10. I’m 22yrs old female. I went to my psychiatrist because my head is filled with ten million things and my brain goes off in all directions at once and makes it impossible to accomplish anything, and it gives me extreme anxiety. My dr prescribed me to vyvanse after I tested positive for add and I went home and read all about it. I really liked everything that was said about how it should help especially with the problems I have, there seemed to be a lot of people having trouble with the sideeffects but that is any medication. So i decide I like what I read and I take it. The anxiety is gone and I no longer have a million thoughts at once, however I feel like now I have no thoughts. I can’t focus on one thing because I can’t even think up one thing. I feel like I can’t comprehend anything and I don’t feel motivated to do anything at all… actually now I’m almost bored though I should easily be able to find stuff to do. Is this normal do I need to take it longer, or is there something better for me.? Everyone says more energy more motivation more focus, I’m awake but not energized at all and just feel like a zombie. I’m literally having trouble constructing this question. I’m taking the 40mg vyvanse once daily.

  11. Horrible for my 6 year old, at first made her way too emontional, then up to 3 times a week up alllll night and most times up all night 3 nights in a row and was only on 20 milligrams

  12. A book, yes, a book. But I’m very happy to share my experience as it’s been life changing.

    Ok, first off my then 8 year old was diagnosed with ADD inattentive type. He started with concerta and it made him a big crying mess. It was horrible! Then, Vyvanse. it was life changing for him. He went from struggling to get B’s with 4 hours of homework, yes 4 HOURS to do his homework to getting all A’s and no homework at night. His confidence is up, he’s got more friends, his hygiene is no longer a mess. He is still the same person, but a more organized and put together person. He’s going to be 10 in a week and it’s changed his life. They wanted to put him in LD classed and this year, he’s going to be in the gifted and talented classes. Meaning 3 grades above his age level for content he’s learning. He couldn’t be happier.

    I was diagnosed after seeing the improvement he had made. I was very much like him in school. too much talking, needs focus, disruptive and so on, on evey last report card. So, I went to a pdoc and was diagnosed. I’m living a different life. I’m still me, same hopes, dreams and ambitions. I just have the focus and the clarity to be who I want to be and not waste it away on the couch.

    My primary concern was it changing my personality. It hasn’t made me any different with exception to how I do things. I don’t forget things like deodorant or brushing my teeth in the am. I care if my clothes are wrinkled. I don’t forget to shave.

    My friends have said that I’m more focused in conversation and not bouncing around like they’ve grown accustomed to.

    There are some physical changes happening. I’m a stay at home dad, which is a self motivated job and lets face it, with ADD we’re not the self motivated type. It was ok to sit on the couch from 7 am to 5pm and run cleaning up messes until my wife got home. Our home was never clean. The change you ask? I’m up at 6am, cook a high protein breakfast, take my pill and eat by 7. from 7-8 I sit on my computer as I use to reading news, talking on facebook and screwing around. at around 8-8:30 it kicks in and I’m ready to do my choirs. I clean my home from top to bottom, not mania, just able to focus on what i need to do. My body still isn’t use to this and I’m tired in the afternoon. it’s better, but still not perfect. I’m also use to relying on caffeine more than I should. I stopped drinking caffeine and changed to water and chocolate milk of all things. I’m also eating healthy meals now, I’m more conscious of what I’m preparing during the day. No longer am I waiting until 5 to start dinner then scrambling. Now, I’m starting to prepare my meals at 12:00 for dinner and have time to properly fix the meal at hand. We’re also eating at the table for the first time ever. A clean table with properly cleaned utensils and clean water spot free plates.

    My wife was concerned at first while texting during the day. She’s an RN and was afraid it was mania. After spending the first weekend she commented “it’s certainly not mania, you’re calmer, and more dedicated to completing your tasks”

    So, for the first time in our adult life together (together since 15 and living together since 16) we have a clean, well organized home and healthy meals.

    I’ve not lost weight, in fact, I’ve gained weight. No, not fat. I’m losing fat and gaining muscle. it looks like I work out now, when really, it’s just me completing things I normally would have stopped and retreated to the couch. My pdoc even told me I was looking in much better shape. My blood pressure is a bit higher, but it was good to begin with and now it’s at 125/75 ish. Not horrible. My pulse sits at an even 75 at rest, which is higher than my previous 65 and higher while being active.

    I suspect people having issues with this med may have a co-morbid illness. For me, I went from being unable to understand math to being able to do anything I pick up. I failed out of math in school and then college 3 times. I now understand advanced algebra. Vyvanse has NOT made me more intelligent. It’s mearly removed the distractions and from what I understand, a portion of my brain isn’t falling asleep when I’m doing something I don’t want to do.

    Lastly, i want to impress one thing on anyone reading who’s unmedicated. thought this is an amphetamine Ii don’t feel hyped up, or stoned, or anything other than awake. I don’t feel jittery, I feel like I’ve been sleeping my entire life. My head is much more clear. I had, since 20 been on xanax for severe anxiety. Now, I don’t take anything of the sort. I don’t get nervous about my perceived failures. I feel like, for the first time in my life I’m succeeding.

    The only problem I have now, is I want to go back to college but until my kiids are all in school full time it’s not an option. I feel like, for the first time in my life I’ve got many things to offer myself, my family and the world.

    If this medicine isn’t working for someone, I’m sorry. It’s life changing for me. The only side effect is the bowel issues, but I think my diet change has exacerbated this. Pepsi was drying me out, now I’m eating like a human being should, and drinking almost the exact amount of water I should be.

  13. Coming from a Vyvanse user myself (2 1/2 months now?) I think this drug has done a lot of good/bad. The drug very much improves my focus. The slight perks are slight euphoria and mood improvement, it also gives you a STRONG sense of motivation that all those things that “couldn’t get done” instantly NOW! becomes the perfect time to get everything done. Now is the time to practice guitar, Now is the time to do homework, Now is the time to plan friends coming over, etc… Me being a very introverted person, vyvanse has significantly improved my ability to talk and have conversation. Now instead of being the quiet kid that nobody ever got to know I can actually hold consistent conversations with people and parents that aren’t simple 1 word answers like “Yes… No, etc… Now the BAD! The only real downsides are the dry mouth (which is bugging me a bit right now lol), the loss of appetite (with me not being a big eater myself the drug has brought my weight down a bit BAD for a skinny person like me :( ) and that’s basically it. I’m a 14 year old boy, introverted and very musical and creative.

  14. I am on 60 Mg of Vyvanse Daily I must say of all the ADHD meds I have used over my 30 yr lifetime (which may seem short to some but long to me) it works the best so far. I Battle Depression severe Anxiety and Also Have 2 children of special needs, so this medicine not only helps me with my ADHD but also with my anxiety. Because I am able to get things done it leads me to have less anxiety. We all know less anxiety means less panic attacks, and I like that a lot!!! Which leads me to not understand the warning on the FDA label about increased Anxiety. My Dr. knows about mine and it has done nothing but help reduce mine so I am thankfull of that but as we all know medicines can be used for more that one thing and Vyvanse has helped with my ADHD and also by doing so reduced my Anxiety so THank YOu Vyvanse…

  15. I to am a victim of ADD. It took many hard and depressing years for me to figure this out. Im 30 years and when I was in first grade I was diagnosed with a learning disability. I cant remember what the diagnosis was but it was no ADD. I was held back in first grade and then again when I was a senoir in Highschool.

  16. I remember for years people would tell me I was a space cadet. I must have heard “your a smart kid but you dont apply yourself” a thousand times. I tried for years to do better in school but I always found myself wondering why I couldnt just buckle down and get my act together. My parents were always dissapointed with my grades. I found my mind wandering at all times during classes. I tried to concentrate but I just wasnt able to; the smallest distraction would instantly change my train of thought. It was depressing I knew I was capable but no one else did and no one else had any confidence in me and eventually I lost all my self esteem. My grades in HS were pitiful and embarssing. Luckily I played football and was able to weasel my way into a world renowned University. Not that it really did me any good. I lasted 2 semesters in college and dropped out because of bad grades. After football was out of my life my ADD led to anxiety and I turned to eating as my way out. I gained 150 lbs. in 6 years and I switched jobs about 10 times. The doctors thought I was depressed and that I had an anxiety disorder. Prozac, Zoloft, Lexapro I tried them all and none of them worked. Finally after multiple misdiagnoses I decided to listen to a friend of mine(who had ADD) who suggested that I might have ADD. I went to a psychiatrist and was diagnosed with ADD. They started me on Vyvanse and the next thing I know my life is back on the right track. Im taking college courses again and getting great grades. Ive been on a diet and lost 70 pounds. Ive been volunteering and making a difference in society just like I always said I would. While Vyvanse may not work for some it has truly turned my life around.

  17. I’m a 61 year old male who wasted a life time not being able to organize my thoughts. I was a constant non finisher, could not read a book, did terrible in school, just could not concentrate on anything. 2 years ago after seeing my adult son with similar lifestyle problems show great improvement on Vyvanse, I went to the doctor and started with 30 mg dose. Was too much. Heart pounded, up all night, BP went up, etc. Went back and asked for less. 20 mg. works wonders. I focus, get things done, have tremendous energy and for me, no side effects that I know off. Occasionally I use a 30 mg tab if I have a lot of stress going on, but the 20′s have done their magic for over 2 years, and as I said – I’m over 60.

    The only “negative” was the slight euphoric feelings, but that may have helped me make it through the recession. I run a small business and there times I probably should have been more reactive and fearful, but I just kept going along with minimal fear. Now that I know this, I try to think it through a little better.

    I have tried to get off the drug (don’t like to take any drugs if I can help it) but all the old problems come back and I waste away my days with my mind spinning over and over with no focus or direction.

    Oddly, my son had to stop taking the drug due to the depression it caused within his mind. We all could see his return to getting nothing done, but we didn’t want him depressed either.

    Hope this helps.

  18. I am a 28 year old female and recently switched from Adderall (30 MG twice daily) to Vyvanse, 60MG. I must say, my focus is amazing and it has forced me to be more extroverted as well. There is so much that I feel is more effective in Vyvanse than the Adderall. Adderall made me feel edgy and more anxious.. With Vyvanse the only downfall, is that it wears down about 5PM and with it comes depression and terrible mood swings. My doctor suggested an increase but I refused as I feel I am overfocused at times. I’ve been on Vyvanse for almost two months and the dosage has not weakend, it’s just the lifespan is too short and the coming down isn’t gradual. I have no problems sleeping at night and when I wake up, I sometimes feel a little foggy but overall good. I’ve had some decrease in appetite and because the medication is absorbed best in the blood, my doctor suggested I take a blood pressure medication called, Propranolol as it can increase your BP and heart rate. I’ve decided to try and take the medication a little later in the day to see if this will help with the lifespan and will keep all interested, posted on the results.

  19. Hi Mskellyanne,

    I was just prescribed the same dosage of Vyvanse and omg you just described my every day since. I have extreme difficulty forming sentences and my mind is uncharacteristically blank, compared to the one million things that are usually running through my mind (and never really done) Occasionally I get a spark of inspiration or motivation to work, but most of the day I’m in a zombie like state focusing on things that are really of no importance. Did your symptoms ever subside or improve? Please share…thank you!

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