Vyvanse is a unique form of stimulant medication that is most commonly used to treat ADHD and binge eating disorders. Its unique properties give it a long duration of action and a lower risk of abuse compared to other popular stimulant medications, such as Adderall. Read on to discover the uses of Vyvanse, how it works, and what the side effects are.
Note: By writing this post, we are not recommending this drug. Some of our readers who were already taking the drug requested that we commission a post on it, and we are simply providing information that is available in the scientific literature. Please discuss your medications with your doctor.
What Is Vyvanse?
Vyvanse is the brand name for lisdexamfetamine dimesylate (LDX). Vyvanse is a drug often used to treat ADHD in both children and adults, as well as binge eating disorder. It is only available via a doctor’s prescription [R, R, R].
Due to Vyvanse’s slow release, it can be taken once daily. This slow release also significantly lowers the risk of it being abused for recreational purposes. This is one of the main advantages of Vyvanse over traditional stimulants like Adderall [R].
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 [R, R, R, R].
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 [R, R].
The increases in noradrenaline and dopamine are what primarily treat ADHD. The serotonin increase does not treat ADHD directly, although raising serotonin levels may have a 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 [R].
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 much lower abuse risk than other stimulants, as users cannot take very large doses to get a rapid “high” [R].
Vyvanse vs. Other Medications
Apart from the advantages that come from being a prodrug, several studies also show that Vyvanse may be more effective than other common stimulant medications.
A 7-week study in children and adolescents with ADHD found 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 [R].
A literature review of many different ADHD studies (randomized controlled trials) 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 best treatment option in 99.96% of all cases [R].
Uses of Vyvanse
1) Improves ADHD Symptoms 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 [R].
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 frontal cortex, a region of the brain associated with attention and self-control (“executive function”) [R, R, R].
Like many other ADHD medications, Vyvanse improves both the “inattentive” and “hyperactive” groups of symptoms. In a 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 significantly decreased symptom severity within the first week of treatment [R].
In a study (double-blind randomized controlled trial) on 314 adolescents diagnosed with ADHD, 69.1% of the adolescents treated with Vyvanse showed improvements in their symptoms (compared to the 39.5% who improved with the placebo) [R].
Another study on 191 children and adolescents found that Vyvanse significantly improved symptoms in 77% of the participants. Most patients felt 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 [R].
2) Improves 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 [R, R].
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 [R, R].
A 4-week study (double-blind randomized controlled trial) in 420 adults with moderate to severe ADHD showed that Vyvanse significantly improved symptoms within the first week of treatment. About 60% of all the patients who received Vyvanse experienced significant improvements in their symptoms (compared to 29% on placebo) [R].
Vyvanse begins working quickly, with adults showing improved symptoms starting just 2 hours after ingestion. A study (double-blind randomized controlled trial) of 103 adults found that Vyvanse increased productivity in a simulated workplace environment in participants with ADHD [R].
In a 4-week clinical trial of 127 adults with ADHD (open-label), Vyvanse improved symptoms (including both “inattentive” and “hyperactive” symptoms) in ~80% of all patients [R].
3) Reduces Binge Eating
Binge Eating Disorder (BED) affects 1-2% of the population and involves episodes of compulsive, uncontrollable over-eating (without other “compensating” behaviors, such as intentional starvation, self-induced vomiting, or excessive exercise). There are a number of physical ill-effects associated, including obesity. Despite all this, there is currently a lack of effective treatments [R].
In two studies (double-blind randomized controlled trial) in 773 adult BED patients, 12 weeks of treatment with Vyvanse was safe and reduced the number of binge eating days per week by an average of 3.87 days [R].
Vyvanse again reduced the number of binge eating days per week in a 26-week study (double-blind randomized controlled trial) of 418 adult participants with moderate to severe symptoms. Vyvanse also lowered the risk of relapse 11 times more than the placebo [R].
4) Improves 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 [R, R].
A crossover study (double-blind randomized controlled trial) in 14 post-menopausal women found that Vyvanse improved attention and self-control (“executive function”) better than placebo [R].
In another study (double-blind randomized controlled trial), Vyvanse improved attention, processing speed, and working memory in 32 women who either currently going through or transitioning into menopause [R].
5) May Treat Chronic Fatigue
Chronic fatigue syndrome (CFS) affects 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 over-exertion or poor sleep). Other common symptoms include short-term memory loss, slower reactions, and brain fog [R].
Vyvanse decreased fatigue, reduced pain, and improved attention and self-control in a sample of 26 CFS patients in one study (double-blind randomized controlled trial) [R].
In one case study, a 38-year-old woman with CFS reported chronic fatigue, short-term memory problems, and “brain fog”. Vyvanse reduced her fatigue and pain were, and her motivation increased. It was so successful that she was able to withdraw her application for disability benefits, and also no longer needed to take antidepressants [R].
6) May Reduce Cocaine Cravings
Researchers have previously treated cocaine dependence with amphetamines. However, most amphetamines have a high potential for abuse and can be dangerous in high doses. This makes most amphetamines less than ideal for treating people who have previously developed an addiction to cocaine.
However, because Vyvanse is a “prodrug” that is only gradually activated and released into the blood at a steady rate, it has a much lower risk of abuse than other amphetamines. This makes it better suited for treating cocaine dependence [R].
One study found that giving Vyvanse to monkeys reduced their tendency to choose cocaine injections over food rewards. This suggests that taking 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 [R].
Similarly, a 14-week pilot study (double-blind randomized controlled trial) found 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 [R].
Side effects are commonly reported by individuals taking Vyvanse.
In a 2-year study on adolescents, nearly 90% of participants reported experiencing mild or moderate side effects as a result of taking Vyvanse [R].
A 4-week study of adults with ADHD found that 79% of patients reported side effects from taking Vyvanse, which were more likely at higher doses [R].
A study of 773 Binge-Eating Disorder (BED) patients found that more than 50% of participants reported side effects from taking Vyvanse. However, most of these were relatively mild, and included dry mouth, difficulty sleeping, and headaches (only 7 out of the 773 participants in this study experienced more serious side effects) [R].
Digestive System Side Effects
More than 5% of participants taking Vyvanse reported the following side effects. They have been determined to be a result of Vyvanse.
The following are those related to the digestive system:
- Decreased appetite [ R, R, R]
- Weight Loss [R, R, R]
- Nausea [R, R, R]
- Dry Mouth [R, R, R]
- Constipation [R, R]
- Diarrhea [R, R]
- Anorexia [R, R]
- Stomach Pain [R]
- Vomiting [R]
Head, Brain, and Psychological Side Effects
The following are side effects related to mood or the brain:
- A headache [R, R, R]
- Insomnia [R, R, R]
- Irritability [R, R, R]
- Increased aggression [R]
- Tics / uncontrolled movements [R]
- Feeling Jittery [R, R, R,]
- Fatigue [R, R]
- Anxiety [R, R, R]
Other Side Effects
Some other common side effects:
Heart Side Effects
Vyvanse also has the following heart 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 [R].
While taking Vyvanse, make sure you consult your doctor before starting any other kind of medication. This includes over-the-counter medicines, vitamins, or herbal products [R].
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) [R].
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
The dosage used to treat ADHD is typically between 30-70 mg/day and is the same for both adults and children [R].
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 shown to be the most effective in treating ADHD, leading to significant symptom improvements in 76% of all participants [R].
50 and 70 mg/day is the typical amount suggested for treating BED in adults [R].
For treating the cognitive symptoms of menopause, a study found that dosages between 40-70 mg/day were safe and well-tolerated by the menopausal women [R].
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 [R, R, R, R, R, R, R, R].
Most drug studies also generally exclude participants with heart conditions for safety reasons. However, Vyvanse (and amphetamines in general) are known to have heart side effects in some people, although generally minor. It remains unknown, though, whether people with pre-existing heart conditions might be at greater risk of heart side effects [R, R, R, R, R, R, R].
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 [R, R].
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 could be gained by future studies with larger sample sizes [R, R].
Vyvanse is mostly activated in the blood and in the liver. Certain genes can affect how your body processes D-amphetamine, the primary active ingredient of Vyvanse.
A compound called flavin-containing monooxygenase (FMO) may trigger the metabolism of amphetamine. In humans, the FMO3 gene determines the rate at which amphetamines get broken down and removed by the liver [R].