Vyvanse: What You Need To Know

Vyvanse is the new ADHD medication from Shire PLC, the makers of Adderall XR. It marks a significant change in the range of medication available as it uses a different type of stimulant than other medications, it a has long duration and it is especially formulated to prevent substance abuse.

How Vyvanse Works

The active substance in Vyvanse is lisdexamfetamine and is chemically very close to Dexedrine Spansules, a stimulant occasionally prescribed for ADHD. The advantage of lisdexamfetamine over methylphenidate (used in Ritalin and Concerta) is that it has a long lasting effect. Taken in the in the morning, the peak effectiveness last one to four hours but had a notable effect on symptoms for 12 hours.

Traditional ADHD medications have been easy to abuse and this has led to dependency problems. Vyvanse is a prodrug, a substance that is inert until it is digested. This mimics how the body creates useful chemical and vitamins from our food. As Vyvanse only acts as a stimulant once it is broken down by the stomach you cannot get a high from grinding it up and snorting it. Swallowing higher than prescribed doses (150mg compared to the recommend max of 70mg) will still produce a high indistinguishable from that produced by a comparable dose of Ritalin.

Vyvanse: Four Times More Side Effects

Because Vyvanse is new it has only been used by those adults and children who took part in the drug’s trials. In total, less than 1000 people. With such a small sample (compared to the millions who will end up taking the drug) there is very little first hand knowledge of the drugs effects. With each of the other major drugs, Ritalin, Adderall etc, different people can have very different reactions to the drugs. Someone who is fine on one drug may have numerous side effects from a chemically very similar drug. The body and brain are very complex chemical systems and stimulants are a very crude tool.

Currently we only have the Vyvanse prescribing information to go on as a guide to its effects but one things is very noticeable. In trials 10% of users stopped taking the drug due to adverse effects (i.e. side effects). This is much higher than Adderall where only 2.4% of participants were effected. In the Adderall trials more people stopped using the placebo than the real drug but for Vyvanse only 1% of placebo users dropped out. The new drug has a side effect rate 10 times higher than the base line and four times high than Adderall.

Vyvanse And The $1.5 Billion Goal

Shire PLC are introducing this new drug as a replacement for Adderall XR whose patent is running out. They hope to capture 50% of the market share with the drug and as the market is worth $3 billion, a 50% share will generate a lot of money. Expect to see a lot of advertising aimed at parents, not doctors, when Vyvanse is launched in July. In theory Vyvanse is a lot cheaper to make than competing drugs as its chemical formula is its key rather than the complex release mechanisms used by others drugs. However I expect that Vyvanse will retail at about the same as the other ADHD medications at about $130 – $150 for a months dose.

454 Comments

  • kate says:

    Having taken both, I have to say that, in short, Adderall is much better than Vyvanse.

    Jump on the Adderall train while you have the chance.

  • Dallasite says:

    I started on 30mg Vyvanse about 1.5 years ago. Long story short, I bumped up to 50mg and take 1/2 of it day. 30mg was too much for me, 25mg seemed to be just right. Anytime I took the full 50mg, I wigged out and felt compelled to clean and rush around without really being able to get anything started.

    The BAD:
    1) Severe inability to get it up while taking it. It’s like the big guy down there isn’t connected to the rest of me, no matter how turned on I am in the head. This is starting to become a deal-breaker for me. I have a hot wife and this sucks because it’s literally -impossible- to perform until it wears off.
    2) General paranoia and I get frustrated easily. Then I will turn around and feel inexplicable rushes of pure love for my kids and wife out of nowhere. While that shouldn’t be viewed as bad, I took enough E in my younger years to know the difference between “real love” and “amphetamine induced love”. I prefer to feel it naturally.
    3) I am now fully addicted to it and cannot deal without taking my 25mg a day. I have found that taking it with a lot of food makes a -significant- difference in it’s duration and quality. For those of you who take it on an empty stomach or with coffee (or a small bowl of cereal), you probably get a bigger rush and more side effects and anger. Try taking it with more food and it goes much smoother. Trust me on this.
    4) For some reason, when I talk to people I have a hard time finding a way to phrase what I want to say so that I don’t sound like a complete asshole. Unfortunately, Vyvanse makes me an asshole even when inside my head I’m being genuine and not trying to be one. I did not have this problem when I did not take Vyvanse.

    The Good:
    1) I have always been notorious for having a terrible memory and not being able to hear what people tell me. I’m always off in my own littler universe. I came to the conclusion one day the problem was not a bad memory, but my inability to pay attention long enough to commit things to memory. It was having a very negative affect on my relationship and I was at times a danger to my children because I wasn’t aware of my surroundings. I eventually found vyvanse and my ability to remember and engage in conversation is considerably improved.
    2) It fixed my problems with crashing in the middle of the day. For years, I would simple run out of go-juice and could fall asleep standing up. It would just hit my like a huge tidal wave of exhaustion. I no longer have this and in fact feel compelled to go go go go go all day long.
    3) It is negatively impacting my job. I am having a harder time making decisions and a harder time thinking deeply. It is also impacting my creative side and gives me this pervading sense of hopelessness at times.
    4) If you were a pot-head in school and “grew out of it” like I did, Vyvanse may lead you back. It did for me and now I’m smoking again. That might be whats up with #3 above though.

    Summary:
    Overall, Vyvanse has fixed things, and caused me a lot of problems. I want to stop taking it, but I don’t know what to do because I am addicted to it now. I also don’t want to go back to being the half-aware person who can’t pay attention to save his life or keep his kids from hurting themselves. So, for those of you out there considering taking it, be aware of these affects I have and others have experienced. You -will- become addicted. Of that, have no doubt.

  • Kristy says:

    Oh and parents – the reason you should NOT listen to the people that say “take what you’re giving your children so you know what it feels like first!” is because, obviously, this drug affects people who do not have ADD/ADHD (or a different type therefore requiring different medication) differently. By taking it you are not understanding how they will feel by taking it – if even just because of the fact that their bodies are so much different.

    I’m sure most know this, but the ignorance of the person who actually suggested that compelled me to say no!

  • Kristy says:

    I can’t speak for the effects in children, because I’m a 23 yr old ‘adult’ with more of an inattentive/impulsive ADD. My sister has ADHD and is inattentive/impulsive and very hyperactive. She is the reason my eyes were opened to Vyvanse, because after different dosages of Adderall were ok here and there, Vyvanse is something she’s tried that gives her a more stable, consistent effect of being able to concentrate, prioritize, and get things done. It lasts for about 8 hrs for her, 10 for me. We’ve both taken the 50 mg.

    For the people who snort it – ARE YOU CRAZY?!? The fact that you’re saying the claims that Vyvanse is not addictive is false is just ludicrous. These claims were based on tests where people took their correct dosage in the correct way. The people snorting or taking 15 pills at once and staying up for days disgusts me. They weren’t saying ‘OK – see if you can get high on this!’ It makes me feel like the people doing that are people who have abused drugs before and are just trying to ‘chase the high’. You are the reason it was actually a lot harder for me to find a reputable doctor to give me a RX (college student doesn’t help cause these kids on campus pop them like they’re candy with no worries about the effects it has on their heart or their bodies). IN LAMENS TERMS: people who aren’t out to get a high and want medication to be able to function again – or even learn what that is, in my case – are not going to accidentally find themselves addicted to amphetamines by taking Vyvanse on a regular basis. They won’t find themselves in a situation similar to when someone has a very painful and serious injury who starts taking pain meds to deal with the pain, and then finds themselves addicted – something they never wanted. So yea, if you want to get high then swallow the bottle or snort it. For those of us who want to take it to be able to function in general, we are not going to have the problem of trying to chase the high, because that’s not what we’re after. I’m sorry – I can’t say that I empathize with those people because I’m AFRAID of the high. (Which is why I reluctantly took any medication for my ADD but am now so glad I did.) Maybe I’m a control freak, but I don’t like one bit the thought of handing my control or urges over to a substance. I don’t want to have to go through the struggle of taking back my life – I’ve seen the alcoholics in my family struggle with it and it’s just plainly something I don’t want to have to ever do, so I’m not going to knowingly put myself in a situation where I will have to go down that path in my life.

    Dosage amount is a very important thing – just like Adderal, if you don’t have a high enough dosage or one that is too high, the way it effects you is going to be different. Google “adhd medication +plasma concentration” and take a short lesson in biochemistry and that will tell you all you need to know about why different ADD/ADHD medications/doses do different things to different people. Especially the dosage part.

    I can’t speak on anything other than Vyvanse and Adderal, because I’ve only taken Vyvanse and my sister has taken both Vyvanse after trying to find a balance with Adderal and never being able to do so. It breaks my heart to read the stories of children that can’t find the peace that I have in Vyvanse – or any medication they’ve tried so far for that matter.

    Readers – please remember there’s no blood test or other type of biochemical test that people can take and be told ‘you have ADD/ADHD, and it is ‘this’ type’ and for that matter there are no other problems going on that compound it. Some people take YEARS to find out what’s really going on and if something else was there along w/ADD, or if they were mis-diagnosed. I think it’s on the NIMH website that they list the different ‘uppers/downers’ that need to be given in relation to the type of ADD/ADHD a person has. Testing is very subjective, and we’re still learning about the different types (I know of eight so far). There can be other chemical imbalances that affect the person as well (I’m on a low dose of birth control I started before I found out I was ADD which helped the ups and downs – which were not manic) and there are a lot of misdiagnosis as well, because like I said there’s no true ‘yes’ or ‘no’ test for ADD/ADHD.

    Finally! The way it effects me – My mood is VERY balanced, I have anxiety and depressive symptoms (not to the point where I’ve been diagnosed with any anxiety or depression) because of my inability to succeed to what I feel is my potential, which gives me the depressive symptoms, and the anxiety comes from being overwhelmed because I can’t prioritize and even do something as simple as pay bills on time. I was constantly worried that I would forget something important, because no matter how many different ways I tried to keep track of everything something would fall through the cracks. Vyvanse alleviated all of my anxiety and depressive symptoms and finished balancing out my mood because I felt like I was able to handle things like I’ve felt like I should be able to my whole life. It wasn’t the actual medication that relieved those symptoms, it was because I could function that any anxiety or depressive symptoms no longer affect me like they do. PILLS DON’T CREATE SKILLS!! Behavioral therapy is EXTREMELY important – whether you’re taking meds or not. Anxiety compounds the problems that people have with ADD/ADHD, and if I get anxious when I’m taking a test, it makes me ‘feel’ my ADD symptoms increase and start to affect me. I need to calm down and help the meds help me think clearly and at a pace where it’s not flying around in my head too fast to grasp. I look at meds as a way to find what those skills are for me and the best way to develop them so someday I might be able to life w/out taking meds, and embrace the fact that I can do 20 million things at once and think about a lot more things at once than a person w/out ADD. The first few days gave me a craving for water (but I didn’t drink as much as I needed before and after re-hydrating didn’t feel it after the first few days). I had a headache the morning after – never during – that went away after the 2nd day and I think it had to do with the dehydrated state I was in when beginning the medication. My appetite returned after the 2nd day as well. Keep in mind this is the first medication I’ve ever tried for ADD and I’ve never abused drugs. The ONE TIME I had a RX that wasn’t allergy medication or birth control, it was a tylenol/oxy combo, and I found myself barely needing them after all four of my wisdom teeth were taken out (eating solid food the next morning with care) I never finished the bottle and only took half doses because that’s all I needed. My body is different than yours, your son, or your daughter, but I hope that this might at least give you some peace of mind that I was able to take Vyvanse and it worked for me. I wasn’t looking for a high, and have not found myself addicted – my biggest fear with a medication that is supposed to be taken daily.

What are your personal experiences with ADD / ADHD, autism or dyslexia?