Lisdexamfetamine (Vyvanse)

Lisdexamfetamine, or Vyvanse, is a central nervous system stimulant used to treat attention-deficit hyperactivity disorder (ADHD) and binge eating disorder (BED). Though Vyvanse is safe and effective for children and adults, there are many side effects, including, but not limited to, anxiety, circulatory problems, and insomnia.^[1]

Lisdexamfetamine brand names

Lisdexamfetamine is sold in the United States under the brand name Vyvanse.

What is lisdexamfetamine prescribed for?

Lisdexamfetamine, a type of amphetamine, is an ADHD medication for children (six years of age and older) and adults. It prevents the reuptake of dopamine and norepinephrine in the brain, which helps reduce ADHD symptoms (e.g., trouble focusing, impulsivity).^[1]

Vyvanse is also prescribed to adults with binge eating disorder (BED). Again, this stimulant affects the brain by increasing dopamine and norepinephrine levels, which results in reduced BED symptoms (e.g., instances of uncontrolled eating).

How does lisdexamfetamine work?

As noted above, Vyvanse increases dopamine and norepinephrine levels in the brain by blocking its reuptake. More specifically, these neurotransmitters are prevented from entering the presynaptic neuron. As a result of this action, the levels of both neurotransmitters are increased in the extraneuronal space.^[1]

With more dopamine and norepinephrine in the extraneuronal space, many patients experience improvement in common ADHD symptoms, such as:^[2]

• Improved focus on tasks
• Reduced impulsive behaviors
• Reduced hyperactivity

Vyvanse works the same in adults with BED. With more dopamine and norepinephrine in the brain, BED patients might experience a reduced desire to binge eat with fewer binge days per week.^[3]

How is lisdexamfetamine usually taken?

Vyvanse is an oral medication that comes in capsule or chewable tablet forms. It can be prescribed in various dosages: 10-70 mg capsules and 10-60 mg chewable tablets.^[1] Typical administration is one capsule or tablet once daily in the morning. Vyvanse can be taken with or without food.^[4]

How long does lisdexamfetamine stay in your system?

Vyvanse reaches maximum absorption in the body approximately one to three-and-a-half hours after the dosage is administered in pediatric and adult patients who have fasted before taking the drug.

Vyvanse chewable tablets are maximally absorbed in about one to four-and-a-half hours in both pediatric and adult patients. Again, this timeframe is achieved when patients have fasted before the dosage is administered. Timeframes for maximum absorption might be longer in real-world settings.^[1]

This ADHD medication has a mean plasma elimination half-life of approximately 12 hours. Patients who take a 70mg dose – the maximum for this drug – eliminate about 96 percent of the drug via urine and feces over approximately 120 hours.^[1]

Lisdexamfetamine side effects

As an ADHD medication, Vyvanse might cause mild to severe side effects in children and adults. These symptoms are outlined below.

Mild lisdexamfetamine side effects for ADHD patients

These side effects are common and typically well tolerated. But, if you experience intense or prolonged symptoms like those listed below, contact your doctor immediately.^[1]

• Anxiety
• Irritability
• Difficulty sleeping
• Decreased appetite
• Weight loss
• Dry mouth
• Upper stomach pain
• Diarrhea
• Vomiting
• Nausea
• Dizziness

Severe lisdexamfetamine side effects of ADHD patients

The following symptoms are far less common yet pose a significant health risk. If you experience these symptoms, stop taking Vyvanse immediately, contact your health provider, or get emergency medical attention.^[4]

• Vision problems (including blurred vision)
• Swelling of the face, eyes, mouth, tongue, or lips
• Weakness or numbness of extremities
• Paleness in fingers or toes (or skin with a blue appearance)
• Pain, temperature sensitivity, or numbness in the fingers or toes
• Unexplained wounds on the fingers or toes
• Hives or rash
• Seizures
• Motor or verbal tics
• Slow or difficult speech
• Hallucinations or delusions
• Mood swings
• Feeling suspicious of others

Mild lisdexamfetamine side effects for BED patients

Vyvanse’s side effects for BED patients are similar to those for ADHD patients. Again, side effects might be mild to severe, as outlined below:^[1]

• Anxiety
• Increased heart rate
• Dry mouth
• Decreased appetite
• Constipation
• Difficulty sleeping
• Feeling jittery

The symptoms listed above are usually well tolerated. However, if they become severe or you experience these symptoms over a long period of time, contact your medical provider.

Severe lisdexamfetamine side effects for BED patients

These symptoms are considered extremely dangerous and might present a medical health emergency. If you experience any of the symptoms listed below, stop taking Vyvanse and seek medical treatment immediately.^[3]

• Increased heart rate
• Increased blood pressure
• Fever or sweating
• Circulatory problems (e.g., paleness or blue skin in the fingers and toes)
• Pain, temperature sensitivity, or numbness in the fingers or toes
• Hallucinations
• Feeling suspicious of others

Both ADHD and BED patients have experienced other side effects as well. If you are concerned about how you feel while taking Vyvanse, contact your doctor or pharmacist to determine if you’re experiencing other effects of the drug.

Lisdexamfetamine precautions

First and foremost, Vyvanse is a Schedule II controlled substance. Extreme care is necessary when taking this drug to ensure proper dosage and minimize the chances of overdose, abuse, or dependence. As with any medication that is potentially addictive, you should always discuss the likelihood of dependence with a mental health profession before taking it yourself.

Additionally, your doctor or pharmacist needs to know if you have allergies to Vyvanse or other stimulants, if you’re taking any MAOIs, or if you recently stopped taking an MAOI. Your doctor should also know what other prescription and over-the-counter medications you’re taking and any herbal supplements, vitamins, or nutritional supplements you take.^[4]

It’s necessary to provide a thorough medical history to your doctor as well. In particular, heart problems (e.g., high blood pressure, irregular heartbeat, heart defect), mental health disorders (e.g., depression, bipolar disorder, Tourette’s syndrome), and Raynaud’s syndrome (abnormal blood flow to the toes, fingers, nose, and ears) can become worse when taking Vyvanse.^1]

Tell your physician if you plan to become pregnant, are pregnant, or are breastfeeding, as Vyvanse could negatively affect the fetus. Moreover, some patients experience reduced alertness and coordination. As such, you should not operate a motor vehicle or other machinery while on Vyvanse.^[4]

Lisdexamfetamine interactions

Research shows that Vyvanse has significant interactions with several types of prescription drugs. Tell your doctor if you take any of the medicines listed below.

MAOIs

MAOIs like isocarboxazid, tranylcypromine, and phenelzine slow the metabolism of amphetamines like Vyvanse, the result of which is an increase in the effects of Vyvanse.

Symptoms include headaches, hypertensive crisis, and malignant hyperpyrexia (increased body temperature, muscular rigidity, and metabolic acidosis), which can be fatal.^[1]

Avoid taking Vyvanse within 14 days of taking an MAOI to minimize the potential of an interaction.

Serotonergics

When taken with Vyvanse, medications like selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, tramadol, and lithium, among others, increase the likelihood of serotonin syndrome.^[1] Serotonin syndrome is a potentially deadly condition that includes autonomic hyperactivity, neuromuscular hyperactivity, and changes in mental status.^[5]

A lower dosage of Vyvanse may help prevent this interaction, but close medical monitoring is necessary to watch for signs of serotonin syndrome, as it can be fatal.

CYP2D6 inhibitors

These drugs, like paroxetine and fluoxetine (which are also serotonergics), may induce serotonin syndrome. Reducing the dosage of Vyvanse and close medical monitoring are required.^[1]

Alkalinizing agents and acidifying agents

Alkalinizing agents may increase blood levels, which potentiates the action of amphetamines like Vyvanse. As such, Vyvanse should not be taken with alkalinizing agents.

Acidifying agents, on the other hand, might lower blood levels, which reduces the efficacy of Vyvanse. A higher dose of Vyvanse typically resolves this interaction.^[1]

Lisdexamfetamine storage

Vyvanse should be stored in its original container with the lid securely closed. It should be kept at room temperature without excessive moisture or heat exposure. Keep Vyvanse out of sight and out of reach of children and animals.

Since Vyvanse is an amphetamine and a Schedule II controlled substance, it poses risks for the development of drug abuse and dependence. Not storing Vyvanse properly could result in misuse by others and developing a drug dependence or overdose.

Additionally, improperly stored medication might lose its potency. Heat, humidity, and time can reduce the effect of Vyvanse. Consult your doctor or pharmacist before taking damaged or old medicines.^[4]

What to do if you overdose on lisdexamfetamine

An overdose of Vyvanse results in effects that range from mild to severe to potentially deadly. Potentially mild overdose symptoms include:^[1][4]

• Fever
• Restlessness
• Muscle weakness or aching
• Tiredness
• Confusion
• Fast breathing

Severe overdose symptoms include:

• Hallucinations
• Depression
• Nausea, vomiting, diarrhea
• Aggression
• Feelings of panic
• Uncontrollable shaking
• Fast or irregular heartbeat
• Seizures
• Coma

In some instances, serotonin syndrome may develop.

If you overdose on Vyvanse or suspect someone else has overdosed, call the poison control helpline at 1-800-222-1222 or call 911 immediately.

Frequently asked questions about lisdexamfetamine

What is the difference between Adderall and Vyvanse?

The primary difference between Adderall and Vyvanse is that the latter is a prodrug – an inert substance that must be metabolized by the body to activate. As a result, Vyvanse has fewer and less severe side effects than Adderall and has a much lower risk of dependence and abuse.^[2]