Switching from Adderall to Vyvanse

Patients receiving treatment for attention deficit hyperactivity disorder (ADHD) often need to change their medication. Switching medication is often recommended by healthcare professionals when ADHD symptoms are not controlled or there are unacceptable adverse effects. There are many ADHD medication treatment options to consider. How and when to switch medications should be done under your doctor’s medical advice and guidance. Several questions arise when changing medications and this blog will focus on switching from Adderall to Vyvanse.

What is Adderall?

Adderall contains mixed amphetamine salts and is available in two formulations: Adderall IR (immediate-release) is short-acting and Adderall XR (extended-release) is long-acting. We will focus on Adderall IR in this blog.

Adderall contains four different kinds of amphetamine salts – amphetamine sulfate, amphetamine aspartate, dextroamphetamine saccharate, and dextroamphetamine sulfate.

Adderall IR is indicated for the treatment of:

• Attention Deficit Hyperactivity Disorder (ADHD) in adults and children over 6 years old
• Narcolepsy

What is Vyvanse?

Vyvanse is an FDA (U.S. Food and Drug Administration) approved medication manufactured by Shire PLC. Vyvanse is the brand name of lisdexamfetamine dimesylate, a derivative of amphetamine. Vyvanse contains the prodrug lisdexamfetamine, which is metabolized into L- lysine, and dextroamphetamine once it is in the body.

It is a prescription drug belonging to a class of drugs known as Central Nervous System stimulants.

Vyvanse is used to treat:

• ADHD in adults, adolescents, and children over the age of 6 years
• Moderate to severe binge eating disorder

Vyvanse is not recommended for weight loss and obesity. Vyvanse is a prescription stimulant medication but is also classed as a Schedule II controlled substance. As a controlled substance, doctors usually prescribe small doses.

Other drugs included in the class of Central Nervous System stimulants include Concerta (methylphenidate), and Ritalin.

How do Adderall and Vyvanse work in the body?

Adderall and Vyvanse belong to a class of drugs known as amphetamines. By working on the central nervous system Adderall and Vyvanse increase activity in areas of the brain that help you with your concentration and behavior. They work specifically on the chemicals dopamine and norepinephrine in the brain. These neurotransmitters, dopamine, in particular, are involved in feelings of pleasure, focus, and finding things interesting. Stimulant medications reduce the symptoms of ADHD making conditions such as inattention, poor decision making, and poor impulse control much less of a daily problem.

One important difference is that Vyvanse is a prodrug, meaning lisdexamfetamine is converted into dextroamphetamine once it is in the body. Vyvanse remains inactive until the body breaks it down in the bloodstream. This is not the case with Adderall.

How long does it take for Vyvanse to work?

It will take about 1 to 3 hours for Vyvanse to work when taken on an empty stomach to reach its maximum level in your blood. If a Vyvanse chewable tablet is taken on an empty stomach it will take slightly longer to kick in. Vyvanse can provide a much more steady experience due to the slower speed of absorption.

It is important to remember these timings are rough estimates because several factors need to be taken into consideration such as drug tolerance, weight, height, and sleep patterns to name a few.

For Vyvanse to start working in your body, lisdexamfetamine must react with your blood and be converted into the active drug dextroamphetamine. Vyvanse is a prodrug, meaning it is converted from an inactive form into an active form in your body by chemicals or enzymes.

Forms and dosages of Vyvanse

The recommended starting dose of Vyvanse is 30 mg. Your doctor may periodically increase or decrease your dosage to help control ADHD symptoms and manage any side effects. You’ll work with your doctor to find an ADHD dose that’s best for you.

Vyvanse is a available in chewable tablet form in the following doses: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg & 60 mg.

Vyvanse is also available in capsule form in the following doses: 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg & 70 mg.

How long does it take for Adderall to work?

It will take Adderall around 30 minutes to 1 hour to start working in your body, therefore having a faster absorption rate than Vyvanse. You can experience increased energy and focus quicker, which may be useful if you need immediate relief from ADHD symptoms. Just like Vyvanse, these duration times are just approximate.

Forms and dosages of Adderall

Adderall IR is available in tablet form in the following doses: 5mg, 7.5mg, 10mg, 12.5mg, 20mg and 30 mg.

Doctors will usually prescribe a lower dose when you first start taking a medication and gradually titrate it until they find the right therapeutic dose for you and your symptoms.

Adderall vs Vyvanse

Adderall is a similar medication to Vyvanse. Both are central nervous system stimulants derived from amphetamines, and both are used for the treatment of ADHD. Vyvanse is also used for the treatment of binge eating disorders (BED), but Adderall isn’t.

Although the two medications are similar and work in a similar way, they contain different active ingredients. Adderall contains four different kinds of amphetamine salts, whereas Vyvanse only contains lisdexamfetamine, which is converted to dextroamphetamine inside your body.

Both Vyvanse and Adderall are effective treatments for ADHD, and they both cause similar side effects. Vyvanse only has an effect once it’s been converted into your body. It’s thought to have a lower risk of substance abuse than Adderall because it’s manufactured to have a slower rate of chemical release and requires enzymes in your body to convert it into its active form.

Vyvanse metabolizes slowly, allowing it to work longer than Adderall. Adderall metabolizes quickly and is absorbed through the gastrointestinal tract. Differences are seen in the onset of action time. Vyvanse takes around 1 to 3 hours to work depending on the formulation and its effects last up to 14 hours when taken once daily. Adderall is normally prescribed twice daily, it takes about 30 minutes to 1 hour to work, and its effects last 4 to 5 hours.

When is it recommended to switch From Adderall to Vyvanse?

• When Adderall is not providing symptom control over the course of the day and Vyvanse is more appropriate as it is longer acting
• Taking Adderall twice a day is not convenient and once-daily Vyvanse is better for you
• You may be diagnosed with binge eating disorder and Adderall can not be used. so a switch to Vyvanse is needed to treat both ADHD and binge eating disorder

Stimulants are powerful medications that wear off rapidly. They’re also completely eliminated from your body by the end of their specified duration, so it’s possible to stop taking them one day and start another stimulant on another occasion. Your doctor will tell you how this transition should be made when changing from Adderall to Vyvanse.

Are Adderall and Vyvanse safe to use?

Lisdexamfetamine, the active ingredient in Vyvanse, is a controlled substance that can be abused and become habit-forming. Vyvanse has the potential to be addictive. However, when used as prescribed to treat a medical condition, Vyvanse shouldn’t become habit-forming.

Lisdexamfetamine is converted in your body into dextroamphetamine, which is an amphetamine. Amphetamines can be used as a recreational drug. This is where they aren’t used as prescribed or to treat an indicated medical condition.

Recreational use, particularly heavy use of amphetamines, can lead to physical dependence (addiction). It can alter the way your body works. You can also become more tolerant of them, requiring higher doses to get the desired effect.

Vyvanse has less potential to be used recreationally than other amphetamines, as it’s slower acting, and won’t be absorbed quicker if it’s crushed or ground up. If used as directed by a doctor to treat ADHD or BED, it shouldn’t become addictive. Research has also shown that long-term use of stimulants from childhood to treat conditions like ADHD reduces the chances of addiction. Your healthcare provider should assess your risk of Vyvanse addiction before prescribing and should monitor you while you take it.

Adderall in contrast has more potential to be addictive as it is faster acting than Vyvanse and will be absorbed quicker. Because it works quickly when crushed up and used it may have a higher potential for misuse.

Vyvanse and Adderall are Schedule II drugs, which means there is a potential for abuse and dependency. Since Vyvanse needs to be converted in the body, it can’t be inhaled or injected as a way to become high, so it is less likely to be misused than Adderall and other stimulant medications. Always store your medications safely and away from other people.

Adderall and Vyvanse side effects

The most common side effects of Adderall and Vyvanse in children, adolescents, and/or adults with ADHD are:

• Anorexia
• Anxiety
• Dizziness, nausea
• Blurred vision
• Dry mouth
• Irritability
• Insomnia
• Upper abdominal pain, stomach pain, vomiting, loss of appetite, decreased weight, diarrhea, constipation
• Motor tics (repeated muscle movements)
• Increased heart rate

In rare instances, Adderall and Vyvanse can cause more serious side effects. These can include:

• Serious cardiovascular reactions e.g. chest pain
• Sudden death has been reported with CNS stimulant treatment at recommended doses in pediatric patients with structural heart defects or other serious heart problems
• Sudden death, stroke, and heart attacks in adults
• High blood pressure and increase in heart rate
• Suppression of growth – monitor height and weight in pediatric patients
• Circulation problems, such as skin color changes, a cold feeling including Raynaud’s phenomenon
• Serotonin syndrome – an increased risk when co-administered with serotonergic agents (e.g., SSRIs, SNRIs, triptans), but also during overdosage situations
• New or worsening psychosis, bipolar disorder, or mental health issues
• Withdrawal symptoms if you suddenly stop using this medication – severe tiredness, sleep problems, mental/mood changes such as depression
• Severe allergic reactions e.g. hives, shortness of breath

Your doctor will assess the benefits of using Adderall and Vyvanse against your risk of side effects. You are encouraged to report negative side effects or adverse reactions of Vyvanse to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Adderall and Vyvanse drug interactions

Adderall and Vyvanse can interact with other medications, including prescription drugs. In some instances, this can change how it and other medications work. It can even increase the likelihood and severity of some side effects. Medications that are known or thought to interact with Adderall and Vyvanse include:

• Monoamine oxidase inhibitors, MAOIs, (methylene blue, phenelzine, or selegiline)
• Tricyclic antidepressants (desipramine or protriptyline)
• Medications that affect your serotonin system (SSRI or SNRI antidepressants, triptans, fentanyl, or St. John’s Wort)

Read the full prescribing information for Adderall and Vyvanse and always speak with your healthcare provider for medical advice about your medicine so they can monitor and evaluate your condition. Always inform your healthcare provider of all your medical conditions, and any medications you are taking, including over-the-counter meds and supplements.

Vyvanse and Adderall are two of the most commonly prescribed ADHD meds. While they both work to relieve symptoms, it may take trial and error to find what works best for you.