two different colored pills sitting in a hand

Adderall vs. Vyvanse: A Comparison

Posted on January 18th, 2018
Posted in Drug Addiction

Adderall (d-amphetamine) is a central nervous system stimulant, comprised of mixed amphetamine salts (75% dextroamphetamine; 25% levoamphetamine). Amphetamines stimulate the brain by increasing the levels of dopamine and norepinephrine, the neurotransmitters involved in hyperactivity and impulse control. Adderall was approved by the U.S. Food and Drug Administration (FDA) in 1996. It is used for the treatment of attention-deficit hyperactivity disorder (ADHD) in adults and children ages 6 and older, as well as narcolepsy. Adderall XR (extended release) is only approved for the treatment of ADHD.

What Is Vyvanse?

Vyvanse is the brand name for lisdexamfetamine dimesylate (LDX), an inactive prodrug that undergoes a biochemical conversion following administration to its active form of d-amphetamine. Like Adderall, it is prescribed for the treatment of ADHD in adults and children ages 6 and older. It was initially approved in 2007 for treating ADHD in children ages 6-12, with subsequent approval in adults in 2008. In 2015, it was FDA approved for the treatment of moderate to severe binge eating disorder in adults. It is not specifically approved for narcolepsy; however, it is sometimes used instead of Adderall.

The most commonly reported adverse event in those who received LDX for ADHD during short-term trials was a decrease in appetite. Although weight loss was not consistently reported in the trials, it is listed as a side effect. Treatment-emergent adverse events reported by at least 10% of binge eating disorder study participants were dry mouth, decreased appetite, insomnia and headache. Vyvanse is not intended for weight loss and its safety and efficacy for the treatment of obesity have not been established.

Administration, Dosing and Half-Life

Adderall: For ADHD, the drug is usually taken once or twice a day with doses at least 4-6 hours apart. The effects of Adderall IR (immediate release) tablets usually last 4 hours or less. Adderall XR (extended release) capsules last 7-12 hours, depending on the individual. The recommended dose is 2.5-60 mg daily depending on age and the condition being treated. Adderall XR is taken once a day with a recommended dose of 5-40 mg administered in the morning. For narcolepsy, the usual dose is 5-60 mg per day in divided doses, depending on the individual’s response. Dextroamphetamine has a half-life of 10-12 hours and levoamphetamine has a half-life of 11-14 hours. In most cases, Adderall is completely eliminated from the body within 3.2 days after the last dose is ingested.

Vyvanse: For ADHD in adults, the recommended starting dosage is 30 mg/day; for children ages 6-12 it is 20-30 mg/day in the morning. Doses may be increased by 10-20 mg/day at weekly intervals with a maximum dose of 70 mg daily. The recommended starting dose for treating binge eating in adults is 30 mg/day with the dose gradually increasing by 20 mg at weekly intervals to attain the recommended 50-70 mg/day.

Following administration, conversion of LDX to d-amphetamine occurs in about 1.5 hours, with effects lasting 1.5-13 hours in children and 2-14 hours in adults. The half-life of Vyvanse is estimated to be about 50 minutes, which means following administration, nearly 50% of an ingested dose will be eliminated from the body in just one hour. The d-amphetamine component has a much longer half-life of 9-11 hours. In most cases, Vyvanse is completely eliminated from the body within 2.4 days after the last dose is ingested.

A 30 mg dose of Vyvanse is equal to 8.85 mg of d-amphetamine or 11.8 mg of Adderall. Vyvanse may be a better option for some individuals, while Adderall is a more suitable for others. One big difference is cost because generic options are available for Adderall, but one isn’t expected for Vyvanse until 2023. Taking them together does not provide any benefits and may result in an increased risk of dependence, adverse side effects and abuse.

Abuse Potential

The risk of Adderall abuse is particularly high among high school and college students. According to a 2016 study, Adderall misuse was highest among 18- to 25-year-olds, attributed to a spike in its use as a “study drug.” It can be addictive and lead to sleep disruption, an increased risk of mental health problems (e.g., depression or hallucinations), aggressive or hostile behavior, cardiovascular risks (e.g., blood pressure and stroke) and death.

Vyvanse was reportedly developed with the goal of providing a longer-acting therapeutic drug with lower abuse potential than Adderall. After oral administration, the conversion of LDX to d-amphetamine is thought to occur gradually, reportedly resulting in a prolonged pharmacokinetic profile. This means the drug maintains a low but sustained concentration of amphetamine in the blood, thereby leading to slower effects on dopamine release, less euphoria and a potentially lower risk of misuse.

A recent study compared a similar dosing of d-amphetamine (40 mg) and LDX (100 mg) in 24 healthy individuals. No statistically significant differences were found in the drug’s pharmacokinetic profiles. This suggests Vyvanse may have similar potential for abuse, however, Adderall is likely more abused due to its greater availability and comparatively inexpensive cost.

 

Key Similarities and Differences

Key Traits

Adderall

Vyvanse

Chemical compound

Amphetamine salts (amphetamine and dextroamphetamine) Lisdexamfetamine (converts to dextroamphetamine)

Clinical uses

ADHD, narcolepsy

ADHD, moderate to severe binge eating disorder (BED)

FDA approval dates

IR: 1996, XR: 2001

ADHD: 2007-8, BED: 2015

Age guidelines

ADHD: Age 6+, Narcolepsy: Age 18+

ADHD: Age 6+, BED: Age 18+

Generic

Yes

No (Expected 2023)

Cost without insurance

#30 – 12.5 mg IR: $25

#30 – 30 mg: $275-$375

Extended release

Yes

No

Half-life

10-14 hours

9-11 hours

Elimination from body

3.2 days after last dose

2-4 days after last dose

Abuse potential

High risk

Medium risk

Suppresses appetite

Yes

Yes

For clinical weight loss No

No

 

Price calculations: GoodRx.com

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