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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Comments

  1. I took concerta before Vyvanse and Ritaline. Vyvanse didn’t work on me worth crap, except it made me more and more dehydrated; yes I do have ADHD. My grades started becoming failing grades because vyvanse wasn’t helping me focus and what not. But now that I’m back on concerta, my grades are A’s and B’s once again. I honestly wouldn’t recommend Vyvanse to anyone I know because it’s so useless.

    Also, concerta and ritaline are in fact NOT addictive. My two older brothers and myself have taken them both and we’re perfectly fine.

    • Dear god, I sure hope you’re trolling.
      First off, Vyvanse has nothing to do with dehydration.
      If the med isn’t working, up the dosage or change to another one.

      And…Jesus Christ. Just because a drug is addictive doesn’t mean everyone who as much as touches it becomes dependant on it.

    • I would like to nicely say that YOU cannot say that “concerta and ritalin are in fact NOT addictive”. Many thousands of people have become addicted and needed treatment including rehab for their unfortunate acquired addiction to stimulants. It is a proven fact…My son took it for many years and never had any addiction concerns but many others have become addicted. I myself have issues w/ ADHD like you and your brothers. If we were perfectly fine, life would be alot better in my opinion. It is good to hear that yall never had any addiction problems…Sometimes hereditary traits can make one more apt to become addicted.

  2. I have been taking vivance for a couple months now. I had been taking adderal for years (2 10 millagrams per day) however I noticed that I was having terrible come downs off the instant release and was feeling very anxious although it really helped me get things done. Now I am taking 30 millagram vivance and the come down is not as bad although I feel somewhat deppressed while I am on it rather than anxious. I’m not sure if this is the right medication for me. I’m also diagnosed for anxiety so this may have something to do with these anxious and depressive side effects.

  3. Hello, thanks for all the post very helpful. I take 40mg of vyvanse and it last about 6 hrs. So I have went to putting the pill in my butt and it last 10 hrs. Why?

  4. Have there been any studies on vyvanse absorption issues in people who have had gastric bypass? I had R-N-Y gastric bypass. My instestines were shortened to 1.5 meters and digestion starts in the intestines (no food, medications, anything passes through stomach and duodenum).

    I take vyvanse 40 mg – going up to 60 mg next week- and feel no effect. Could it be that I am not ‘absorbing’ the meds?

    • From the article:

      “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.”

  5. My 10 year old daughter is currently taking vyvanse and has been for about a year. Prior to that she tok adderall..she has been diagnosised with adhd, odd,and an anxiety disorder. Other than the low apetite, she has not had side effects. She still has rough moments, but went from 3-4 Hour fits, to being able to calm herself much easier. If your looking for a miracle drug, you are not going to find one…it is hard work, even with adhd meds to help a child with adhd issues. I reccomend counseling too if you are medicating your child…it will help your child and yourself deal with adhd behavior.

  6. 4 month update: started on 20mg stopped working within the month went up to 30mg, and although the effects don’t last as long as they say 10-12 hours, we really don’t want to go any higher. mood leveled out, will still react to new situations, but no highs lows. school improvement in all areas, better interactions with siblings and parents. Biggest complaint is the whole drama of renewing the prescription each month, call doctor, get it in the mail, take it to the same pharmacy, don’t go to far in advance before running out or they won’t refill it. Over all: wish there was a better solution than medication but can’t deny the benefits. he is more confident, balanced, and feels better towards school. will be back in 4 more months.

    • Hi Bill, Just sayin it’s totally possible to abuse any kind of medication controlled or not…But hey, if you wanna talk vyvanse then just look at what Jay wrote on 2-1-12 about how it does not work orally so he thought hey would just try up his butt…Good for him as he said it works that route…To each his own. AND BTW, the drug manufacturers state that is LESS potential for abuse…They do not say it is IMPOSSBLE to abuse it. lololol

  7. Reply to : Kari

    You could just be so use to it. i’m on Vyvanse 50mg. If, let’s say, I don’t take it for a couple of days. I will get migranes, dizzeniss. But it also has to do with the person..

  8. ADHD is like space; We know about it, but were never going to be able to answer ever question and mystery …

  9. ive been taking 50 mgs for almost a year now and yes it has helped with concentration but its worsend my mood swings and has made me feel like im going crazy it got so bad to the point where i had to seek psychiatric help… and in my opinion thats not worth it..since ive been off the medicine i feel a lot better about myself and my mood. just be cautious if you have notticed your mood changing because its not worth losing sight of who you are over it :]

  10. A must read for anyone with these issues. Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia by
    Natasha Campbell-McBride

    Fantastic book!

  11. Just stumbled upon this site while researching Ritalin vs. Vyvanse. My 8-year-old son started Vyvanse a year ago at 20mg. He was upped to 30mg a few months ago as he was losing his focus between 11a-noon everyday at school. Then he started having some hallucinations with the 30mg. Right from the get-go at 20mg, his barely noticeable tics became worse & worse to the point he goes into what we call “full body tics.” The 30mg has not helped his focus after 11am.

    My doctor got concerned over the hallucinations & my son has now been off Vyvasne 30mg for 2 days in prep to start 10mg Ritalin in the morning & take another 10mg at noontime. Why would Vyvanse not be the all-day miracle it was supposed to be? (it never seemed to help in afternoons & evenings were bad). Am I just stepping from one bad med to another?

    • SF,
      Different meds work differently with different people. It does sound like Vyvanse was not right for your son, but this does not mean that Ritalin will will be bad. I have seen several people through the years do wonderfully on Ritalin…and particularly Concerta, the time release version. At this time, there is no easy way to know which medication is the correct one for any individual, but it is quite possible that one of the ADHD medications will help. Also, it has been my experience that some people need a small dose in the later afternoon time even if they are taking an extended release form in the morning. I have seen very few cases where an extended release med has carried a child much longer then when they are getting out of school.

    • SF,
      Miracle drug is a reach. im 30 years old and have had ADD since i was a child. I have issues with my focus and mood, while some drugs work better than others, I still havent found a medication that works perfectly. their will always be pro’s and con’s to every drug. Its what you are willing to work with on the Con side of the drug that makes it work, ( lack of appitite, sleep ect). This with the undersatnding that there is no “fix it all drug”. The best advice i can give you is to keep on trying to find a med and to be honest with the doctor. Encourage your son to be honest with how he feels and what you notice while he is on the medication. With that being said i hope all goes well for you and your family.

  12. Im a 48 year old male with ADD for years I’ve tryed it all, I was tried of taking two & three pills a day of addrell and ritallin . Now I take one 50 mg vyvanse it’s works for me just fine, all day from 8am tell 9pm . All is well with me, this is the best I’ve felt in 30 years for taking any stimulant..

  13. I actually thought that this website had been closed down and was surprised to get a notice from you. I have been ADD all my life and never given medication (but it was never known in the 60s either). I have a son who was on this vyvanse for 15 months and I cannot stress it enough that this medication will have litigation coming in the future, so folks get off this darn stuff. My son hears voices (yes he is now Schizophrenic) – not severe though but I know of others whose children are a lot worse than my son. You may think it is a miracle drug and thank good my insurance would not pay for it anymore and he switched to adderall and now he does not take anything and is doing pretty good. I used to stare out the window in 1st and 2nd grade and never focused but my mother introduced me to crystalized ginger (good and hot) and I never had any more problems with school or most anything. I gave up 2 full ride scholarships from college to get married. There are other things out there. Go and search. I would tell some of them but they will probably not allow it on this site and I will be very surprised if they even allow this message to be broadcast, because Vyvanse has the capacity to make you very, very schizophrenic to the point that other meds will not help the constant voices you will hear. Enough said. I really doubt that this post will be approved but I will try anyway.

    • Thank you so much for your honest letter. I agree, there is so much more out there to take that is natural and does not cause all these scary symptoms. My son is nagging me to take Vyvanse and after reading all the side effects I am going to highly recommend natural solutions like taking the oils, eating well, avoiding sugar and eating a healthy food.
      We should have a site with natural solutions that work.

  14. My 7 year old daughter has been on vyvvance for four months and has been upped four times and she is more emotional and worse mood swings she can’t handle public and has trouble sleeping and never wants to eat and says things about killing herself I think of taking her off the meds and get them changed

  15. I have been on vyvanse now for almost 2 years. And it works great for me! I am currently on 50 mg once a day. With that being said everyone is different and the way the medication works in the body varies from person to person. So just because vyvanse didn’t work for the first person on this forum doesn’t mean that the medication sucks or that it is worthless. It just simply means that for that perticular person vyvanse didn’t work as well for them. Another med might be a better fit for that person. Forums are simply here to help people by sharing your experience with the drug. They are not here for people to bash one another or to bash the drug itself. Forums are nice to have when researching something so let’s just give our experiences and or any helpful advice so these forums can serve their purpose in helping people!

    • You are telling the truth there are so many types of medicine for ADHD. People are looking for honest way in modern medicine to be able to be to function at work and be more effective. I have been looking for help for a long time. Staying focus is very hard at times people are looking for help although there is no cure but medicine will help them cope and deal with it and perform there job effectively. It is a great feeling when you can take in information and do well at work and in college. You just have to stay under doctors care and communicate. This will help you and your doctor come up with the right dose or different medication. I agree with you 100 percent I am starting on the medication and want to see if this will work for me and get back on top of my game in stay focus. I tried Ritilan every nurologist was putting children on this medicine. If you do not take the medicine right there can be issues. No matter what medicine you take side affects are there. You take the one that has the lowest side affects. People need to stop bashing and state the experience that is all. Thanks Molly I can really understand and your statement and pray you continue to do well.

  16. My son is 9 and has tried aderol (didnt sleep and the downers made him puke) focalin (got more vioent) straterra (didnt work at all) concerta (worked at highest doses for a child then suddenly stopped after years of taking it) vyvanse 40mg suddenly stopped working.
    he is also bipolar and is on rispodone .5mg and it dont seem to work either. he gets fustrated real easy and his focus is sparatic. He gets self injurious when he first gets fustrated then when an adult stops him he gets violent….. What options do I have other than institutionalizing him. His psychatrist is over worked and dont have any ideas on what to do other than institutionalzing him. Drs in this field are rare around here. So switching to a different doctor is not applicable. I do not want him institutionalized at that age. Is there any other options?

    • He is too young for an accurate bipolar diagnosis. Is it possible your son has Asperger Syndrome/High Functioning Autism? My daughter is 9 and has this mild form of autism along with a high IQ, she behaves a whole lot like what you describe.For those kids meds don’t help, they need behavioral therapy specific to the condition and you have to learn why and what sets off the meltdowns. Even if he is not ASD, the techniques used and many of the behavior mechanisms are the same for ADD/ADHD kids.. If you are at wits end it is worth it to look into this. His school can help him more if it is this and he gets diagnosed. Look up a comprehensive checklist and go to the doc armed with info. If the doc dismisses your concern, try the behavior modification techniques yourself and see how they work… Dont give up!

    • Also, risperdone will cancel out ADD meds like methylphenidate and any of the amphetamine salts like in Adderall or Vyvanse. It is a dopamine suppressant, stimulant ADD meds are dopaminergic, meaning they promote dopamine production and/or help prevent its reuptake in the brain. Sounds like your doc alsoneeds to retake biochemistry classes.

  17. The title of this blog is incorrect. Vyvanse is neither consistent nor does it come close to lasting 13 hours. I’m on Adderall IR 20 mg in the AM followed by 70 mg Vyvanse and another Adderall 20 mg in the afternoon. I am hungry and tired within 5 hours of taking Vyvanse. The afternoon short acting Adderall doesn’t really do much. I’m very frustrated with results and have tried many different versions o med over the years.

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