Vyvanse is a unique form of stimulant medication that is FDA-approved for the treatment of ADHD and binge-eating disorder (BED). Its unique properties give it a long duration of action and a relatively lower risk of abuse compared to other popular stimulant medications, such as Adderall. Read on to discover the medical uses of Vyvanse, how it works, and what the potential side-effects are.
Disclaimer: This post is not a recommendation or endorsement for Vyvanse. This medication is only FDA-approved for the treatment of certain specific medical disorders, and can only be taken by prescription and with oversight from a licensed medical professional. We have written this post for informational purposes only, and our goal is solely to inform people about the science behind Vyvanse’s effects, mechanisms, and current medical uses.
What Is Vyvanse?
Vyvanse is the brand name for a compound called lisdexamfetamine dimesylate (LDX). Vyvanse is a drug often used to treat ADHD in both children and adults, as well as binge eating disorder (BED). It is only available via a doctor’s prescription [1, 2, 3].
Vyvanse is a central nervous system stimulant with a slow onset and long duration of action. Its effects can last up to 14 hours [4, 2, 3].
Due to Vyvanse’s slow release, it generally only needs to be taken once daily. It is generally believed that this slow release also significantly lowers the risk of it being abused for recreational or other illegal purposes (although abuse is still possible). This is one of the main medical advantages of Vyvanse over traditional stimulants like Adderall [1].
Mechanism of Action
Vyvanse is a “prodrug,” which means that it is a biologically inactive compound that is only turned into an active drug after being processed by the body.
The active ingredient of Vyvanse is d-amphetamine (dextroamphetamine), which is bonded to L-lysine. This means that the d-amphetamine is not active until it is detached from the L-lysine. This process occurs in the blood after the prodrug is digested by the small intestine. The active drug is then gradually converted into the active form in the bloodstream, resulting in continuous delivery of d-amphetamine to the patient [5, 6, 2, 7].
All of the main effects of Vyvanse are due to the d-amphetamine it contains. D-amphetamine is a norepinephrine-dopamine-releasing agent (NDRA) that primarily increases the levels of dopamine, norepinephrine, and epinephrine throughout the brain. It also increases serotonin levels and decreases glutamate, although these effects are generally smaller than its primary effects, and are probably not the biological mechanisms involved in its primary therapeutic effects [8, 1].
The increases in dopamine and norepinephrine are what primarily treat ADHD. The serotonin increase does not treat ADHD directly, although it is believed that increased serotonin levels may have a mild beneficial effect on any anxiety or depression symptoms that might occur alongside ADHD symptoms. D-amphetamine also triggers the release of adrenaline, which is the most likely cause of its effects on the heart [1].
Vyvanse vs. Adderall
As a medical treatment, Vyvanse has two unique advantages over other stimulants such as Adderall. The fact that it is a prodrug means that it is released slowly, which means that it has longer-lasting effects and requires fewer doses to stay effective over the course of a day. The gradual release of its active component also gives it a significantly lower abuse risk than other stimulants, as users cannot take very large doses to get a rapid “high” [2].
Vyvanse vs. Other Medications
Apart from the advantages that come from being a prodrug, several studies also report that Vyvanse may be more effective than other common stimulant medications.
For example, a 7-week study in children and adolescents with ADHD reported that Vyvanse led to symptom improvements in a larger percentage of patients than extended-release methylphenidate, which is one of the most popular medications for ADHD in Europe [6].
Similarly, a literature review of many different ADHD studies (randomized controlled trials, or RCTs) compared Vyvanse to other common medications (such as guanfacine extended-release, atomoxetine, extended-release dexmethylphenidate, and immediate-release dexmethylphenidate), and concluded that Vyvanse was the superior treatment option in 99.96% of all cases [9].
Official Medical Uses of Vyvanse
Vyvanse has been officially approved by the FDA for the treatment of ADHD in adults and children over 6 years of age.
It is also approved for the treatment of binge-eating disorder (BED), although this is significantly less common than its use as an ADHD medication.
1) Treating ADHD in Children
ADHD is estimated to affect between 8-12% of all children worldwide. Its symptoms fall into two general categories: “inattentive” symptoms (such as an inability to focus) and “hyperactive/impulsive” symptoms (such as being unable to sit still). People with ADHD can have one or the other types of symptoms, or both together at the same time [5].
Although it might sound counter-intuitive, these symptoms of ADHD are most commonly treated with stimulants such as amphetamines. While you might think that these would make children more hyperactive, these drugs actually calm them down and make them better able to focus their attention. Amphetamines do this by increasing activity in the prefrontal cortex, a region of the brain associated with attention and self-control (“executive function”) [10, 5, 6].
Like many other ADHD medications, Vyvanse improves both the “inattentive” and “hyperactive” groups of symptoms. For example, in one study (double-blind randomized controlled trial) of 230 children diagnosed with ADHD, children were given either Vyvanse or the placebo for 4 weeks. All doses of Vyvanse were reported to significantly decrease symptom severity within just the first week of treatment [5].
In another study (double-blind randomized controlled trial) on 314 adolescents diagnosed with ADHD, 69.1% of the adolescents treated with Vyvanse were reported as showing improvements in their symptoms (compared to the 39.5% who were reported to respond to the placebo treatment) [11].
Another study on 191 children and adolescents reported that Vyvanse significantly improved symptoms in 77% of the participants. Most patients reported experiencing improvements within the first two weeks of treatment, and Vyvanse continued to be effective at managing their symptoms for up to two years later. This suggests that Vyvanse is a good long-term treatment option for children and adolescents [12].
2) Treating ADHD Symptoms in Adults
Between 50-66% of children who are diagnosed with ADHD will have symptoms that continue into adulthood. It is also estimated that while 4.4% of adults have ADHD, only about 25% of these individuals ever receive treatment for their symptoms [12, 2].
Just like in children, stimulants are the most commonly-prescribed medication for treating ADHD symptoms in adults. Vyvanse is the first long-lasting prodrug stimulant used to treat ADHD in adults that has been approved by the FDA [2, 12].
One 4-week study (double-blind randomized controlled trial) in 420 adults with moderate-to-severe ADHD reported that Vyvanse significantly improved symptoms within the first week of treatment. About 60% of all the patients who received Vyvanse reported experiencing significant improvements in their symptoms (compared to just 29% on placebo) [13].
Vyvanse begins working quickly, with adults reporting improved symptoms within just 2 hours after ingestion. One study (double-blind randomized controlled trial) of 103 adults reported that Vyvanse increased productivity in a simulated workplace environment in participants with ADHD [7].
In a 4-week clinical trial of 127 adults with ADHD (open-label), Vyvanse was reported to improve ADHD symptoms (including both “inattentive” and “hyperactive” symptoms) in ~80% of all patients [14].
3) Treating Binge–Eating Disorder (BED)
Binge-Eating Disorder (BED) has been estimated to affect up to 1-2% of the general population, and typically involves episodes of compulsive, uncontrollable over-eating (without other “compensating” behaviors, such as intentional starvation, self-induced vomiting, or excessive exercise, as is often seen in other eating disorders such as anorexia or bulimia). There are a number of physical ill-effects associated with BED, including obesity. Despite all this, there is currently a lack of generally effective treatments for this form of eating disorder [15].
According to two studies (double-blind randomized controlled trials) in 773 adult BED patients, 12 weeks of treatment with Vyvanse was reported to be safe, and reduced the number of binge eating days per week by an average of 3.87 days [16].
Vyvanse was also reported to reduce the number of binge eating days per week in another 26-week study (double-blind randomized controlled trial) of 418 adult participants with moderate-to-severe BED symptoms. Vyvanse was also reported to reduce the patients’ risk of relapse 11 times more than the control placebo treatment [17].
Other Effects & Applications (Not Medically Approved)
The following studies highlight some of the other research conducted on Vyvanse. However, these findings are all still very preliminary, and have not strongly established a scientific case for using Vyvanse for these uses or conditions.
As always, we at SelfDecode are not endorsing nor encouraging the following uses or applications of Vyvanse; the information below is strictly to inform people of what science currently says about some of its potential effects and underlying mechanisms.
1) May Affect Cognitive Functioning (in Menopausal Women)
Many post-menopausal women report having difficulties with memory, focus, and attention that were not present before going through menopause. Although these cognitive difficulties are often attributed to the hormonal changes that occur during menopause, treating these symptoms with hormones such as estradiol is often not effective enough. As a result, researchers have begun to look at Vyvanse as an alternative treatment [8, 18].
One crossover study (double-blind randomized controlled trial) in 14 post-menopausal women reported that Vyvanse may improve attention and self-control (“executive function”) better than placebo [8].
In another study (double-blind randomized controlled trial), Vyvanse was reported to improve attention, processing speed, and working memory in 32 women who either currently going through or transitioning into menopause [18].
However, despite some of this promising early evidence, much more research will be needed to establish the safety and efficacy of this unofficial potential use of Vyvanse.
2) May Treat Chronic Fatigue
Chronic fatigue syndrome (CFS) has been estimated to affect millions of people per year. CFS patients commonly experience long-term fatigue that cannot be explained by other medical conditions or lifestyle factors, such as overexertion or poor sleep. Other common symptoms of CFS include short-term memory loss, slower reactions, and “brain fog” [19].
However, some early trials have investigated the potential of Vyvanse to alleviate some of these symptoms. For example, Vyvanse was reported to decrease fatigue, reduce pain, and improve attention and self-control in a sample of 26 CFS patients, according to one study (double-blind randomized controlled trial) [19].
However, this is just one preliminary study with some promising early results, and a lot more clinical trials would be needed to establish whether this “potential use” of Vyvanse is both safe and effective.
3) May Reduce Cocaine Cravings
Some researchers have occasionally used amphetamines to help patients overcome dependence on drugs of abuse, such as cocaine. The idea behind this is to find a completely different drug that acts on some of the same mechanisms – in this case, dopamine – and to give that to the patient to reduce the cravings they feel while quitting the primary drug they are addicted to.
However, most amphetamines have a high potential for abuse and can be dangerous in high doses. This makes most amphetamines quite a bit less than ideal for treating people who have previously developed an addiction to cocaine since there is a significant possibility that they will simply move on to abusing the new replacement amphetamine drug instead.
However, because Vyvanse is a “prodrug” that is only gradually activated and released into the blood at a steady rate, it has been claimed to have a much lower overall risk of abuse than other amphetamines. Some researchers, therefore, have suggested that this may make it better-suited for managing cases of cocaine dependence when treating addiction patients [20].
Although this application has not been very highly studied so far, one preliminary 14-week pilot study (double-blind randomized controlled trial) has reported that cocaine-dependent patients who were given Vyvanse reported experiencing fewer cocaine cravings than those who took a placebo. However, the Vyvanse patients did not end up using less cocaine overall than the placebo group, suggesting that while Vyvanse may reduce cravings, it does not reduce drug-taking behavior by itself [20].
While no other similar studies have been done in humans yet, one animal study reported that giving Vyvanse to monkeys reduced their tendency to choose cocaine injections over food rewards. This finding was taken to suggest that Vyvanse may make cocaine less psychologically appealing, and that it might have a potential for reducing cocaine use in human users in a similar way [4].
Nonetheless, given the lackluster findings reported by the single human study above, it’s unlikely that this approach will become an accepted part of conventional addiction treatment anytime soon.
Vyvanse Side–Effects
Given that Vyvanse has met FDA approval for medical use, the majority of scientific evidence supports the overall safety and effectiveness of Vyvanse when used as prescribed, and under the supervision of qualified medical professionals.
Nonetheless, like any drug, there is always at least some potential of experiencing adverse side-effects, and so it’s important to be aware of these.
As always, it is important to let your doctor know as soon as possible if you think you may be experiencing any side-effects from your medication.
Prevalence
Side-effects are relatively commonly reported by individuals taking Vyvanse. Fortunately, however, most studies report that these tend to be relatively mild, and generally don’t strongly deter patients from continuing to take their Vyvanse prescription – presumably because for most patients, the benefits generally outweigh the side effects.
In a 2-year study on adolescents, nearly 90% of participants reported experiencing mild or moderate side-effects as a result of taking Vyvanse [12].
A 4-week study of adults with ADHD reported that 79% of the patients reported side-effects from taking Vyvanse, and that the likelihood of these side-effects grew as doses increased in size [13].
A study of 773 Binge-Eating Disorder (BED) patients reported that more than 50% of participants reported side-effects from taking Vyvanse. However, most of these were relatively mild and included symptoms such as dry mouth, difficulty sleeping, and headaches (only 7 out of the 773 participants in this study experienced more serious side-effects than these) [16].
Digestive System Side-Effects
More than 5% of participants taking Vyvanse reported the following side-effects. They have been determined to be a direct result of taking Vyvanse.
The following are those related to the digestive system:
- Decreased appetite [ 12, 16, 7]
- Weight Loss [12, 5, 6]
- Nausea [12, 16, 7]
- Dry Mouth [16, 7, 14]
- Constipation [16, 17]
- Diarrhea [17, 13]
- Anorexia [13, 6]
- Stomach Pain [5]
- Vomiting [5]
Head, Brain, and Psychological Side-Effects
The following are side-effects related to mood or the brain in general:
- A headache [12, 16, 17]
- Insomnia [12, 17, 7]
- Irritability [12, 16, 7]
- Increased aggression [12]
- Tics / uncontrolled movements [12]
- Feeling “jittery” [16, 17, 7,]
- Fatigue [16, 7]
- Anxiety [17, 7, 14]
Cardiovascular Side-Effects
Vyvanse also has the following potential cardiovascular side-effects:
These heart effects are in the vast majority of studies. However, researchers often argue that these effects are generally not large or severe enough to be a health threat [17].
Other Side-Effects
Some other common side-effects include:
Drug Interactions
Like many prescription medications, Vyvanse can have potentially harmful interactions with other drugs and substances. As always, the safest way to minimize your risk of experiencing negative interactions is to make sure your doctor is fully informed about any other drugs you are taking, as well as any pre-existing health conditions, supplements, or other dietary and lifestyle factors that may impact the course of your treatment.
Because Vyvanse increases the levels of many different neurotransmitters (monoamines), it should not be taken by anyone who is taking (or who was recently taking) any drugs that have a similar effect (such as MAO inhibitors) [1].
Other drugs in the following groups can interfere with Vyvanse’s effects, including [R]:
- Diuretics (such as ammonium chloride, acetazolamide, and hydrochlorothiazide)
- Antidepressants (such as Desipramine, Fluoxetine, Paroxetine, and Protriptyline)
- Vitamin C
- Anti-anxiety drugs (such as buspirone)
- Opioids (such as fentanyl and tramadol)
- Mood stabilizers (such as lithium)
- Drugs used to treat urinary infections (such as methenamine salts and sodium acid phosphate)
- Antiviral medications (such as Ritonavir)
- Drugs for heartburn and indigestion (such as sodium bicarbonate)
- Heart medications (such as quinidine)
- Drugs used to treat headaches and migraines (such as triptan)
- St. John’s Wort
- Tryptophan supplements
Vyvanse Dosage
Note: The information in this section describes typical dose information for medical applications of Vyvanse: it is not a guide to recreational or other non-medical use. Anyone taking Vyvanse by prescription should take care to follow the directions of their doctor as fully and accurately as possible to ensure optimal treatment.
The Vyvanse dosage used to treat ADHD is typically between 30-70 mg/day, and is generally similar for both adults and children [13].
In a study (double-blind randomized controlled trial) on 314 adolescents, patients received 30, 50, or 70 mg per day. The 70 mg/day dosage was reported to be the most effective in treating ADHD, leading to significant symptom improvements in 76% of all participants [11].
50 and 70 mg/day is the typical amount suggested for treating BED in adults [15].
For treating the cognitive symptoms of menopause, a study reported that dosages between 40-70 mg/day were safe and well-tolerated by the menopausal women [18].
Genetics
Vyvanse is mostly activated in the blood and in the liver. There is some evidence that certain genes may affect how your body processes d-amphetamine, the primary active ingredient of Vyvanse.
For example, a compound called flavin-containing monooxygenase (FMO) may be responsible for triggering the metabolism of amphetamine. In humans, the FMO3 gene determines the rate at which amphetamines get broken down and removed by the liver [21].
Limitations and Caveats
Many studies on Vyvanse have specifically excluded patients who have more than one disorder at the same time (“comorbidities”). While this is not unusual for clinical drug studies in general, it does mean that the effects of Vyvanse on people with multiple disorders are not fully known, and caution is advised for patients with more than one psychiatric diagnosis [8, 18, 13, 7, 14, 5, 6, 11].
Most drug studies also generally exclude participants with heart conditions for safety reasons. However, Vyvanse (and amphetamines in general) are known to have cardiovascular side-effects in some people, although these are generally minor. It remains unknown, though, whether people with pre-existing heart conditions might be at greater risk of cardiovascular side-effects, and so special caution is advised for these patients [8, 13, 7, 14, 5, 6, 11].
Since women make up the majority of Binge Eating Disorder (BED) patients, they were also the vast majority of participants in studies on the efficacy of Vyvanse in treating this disorder. The lack of men in these studies means that it is not known for sure if Vyvanse’s effects would be the same for male patients [16, 17].
In many studies – particularly the ones on menopausal women, cocaine users, and patients with CFS – the sample sizes tend to be small. A more complete understanding of Vyvanse’s effects on these populations will need to be gained by future studies with larger sample sizes [8, 18]. This lack of appropriate data is also one of the main reasons why these “potential uses” have not been officially approved by the FDA, as well as why doctors, in general, do not commonly use Vyvanse to address these types of issues.
