Lisdexamfetamine
Generic: lisdexamfetamine dimesylate · Brand: Vyvanse® · Class: Stimulant — Schedule II (Amphetamine Prodrug)
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How It Works
Vyvanse is a prodrug — it is inactive until the body converts it to dextroamphetamine after absorption. This conversion happens slowly in the bloodstream, resulting in a smoother onset and offset compared to other amphetamines, with less euphoria and theoretically lower abuse potential. It provides approximately 12–14 hours of coverage from a single morning dose. The prodrug design means it cannot be effectively misused by crushing or snorting — it must be swallowed and metabolized to become active.
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What It Treats
ADHD in Children 6+FDA-approved; once-daily with the longest duration of any oral stimulant
ADHD in AdultsFDA-approved; particularly valued for smooth, consistent all-day coverage
Binge Eating DisorderFDA-approved — the only stimulant approved for this indication
Lower Misuse PotentialProdrug design makes it less effective if misused — a consideration when misuse risk is a concern
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Dosing Overview
| Population | Start | Typical Range | Max |
|---|---|---|---|
| Children 6+ ADHD | 20–30 mg every morning | 30–70 mg/day | 70 mg/day |
| Adults ADHD | 30 mg every morning | 30–70 mg/day | 70 mg/day |
| Adults Binge Eating Disorder | 30 mg every morning | 50–70 mg/day | 70 mg/day |
Take once daily in the morning with or without food. Capsules can be opened and dissolved in water — drink entire mixture immediately. Do not take in the afternoon. Duration is 12–14 hours.
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Side Effects
Common
- Decreased appetite
- Insomnia
- Dry mouth
- Headache
- Irritability
- Increased heart rate
- Stomach upset
- Weight loss
Call us if you notice
- Chest pain or palpitations
- Severe anxiety or psychosis
- Significant blood pressure elevation
- Serotonin syndrome signs
- Raynaud phenomenon (fingers/toes turning blue or white)
Vyvanse is often described as the smoothest-feeling stimulant with fewer peaks and valleys. The long duration is a major advantage but can cause more sleep disruption — take as early as possible. Raynaud phenomenon (color changes in fingers/toes) is a less common but notable side effect.
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Tips for Success
Take in the MorningTake stimulants early in the day to avoid insomnia at night.
With or After BreakfastFood reduces stomach upset and helps avoid appetite suppression affecting meals.
Watch SleepIf it affects sleep, talk to your provider about adjusting timing or dose.
Avoid AlcoholAlcohol can worsen ADHD symptoms and interact with medication.
Stay HydratedDrink plenty of water — stimulants can cause dry mouth and dehydration.
Track Your ResponseNote focus, mood, appetite, and sleep daily to share with your provider.
Can Dissolve in WaterOpen capsule and dissolve contents in water — drink immediately. Do not store.
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Important Safety Information
Controlled Substance — Schedule II: Stimulant ADHD medications have a high potential for abuse and dependence. Take only as prescribed. Do not share with others. Store securely.
Cardiovascular Risk: Stimulants raise heart rate and blood pressure. Tell your provider about any heart conditions, high blood pressure, or family history of heart problems. Seek emergency care for chest pain, shortness of breath, or fainting.
Psychiatric Effects: Stimulants can cause or worsen anxiety, irritability, agitation, or psychosis — especially at higher doses. Report any new or worsening psychiatric symptoms.
Growth in Children: Stimulants can slow height and weight gain in children. Your provider will monitor growth at each visit.
Do Not Use With MAOIs: Combining stimulants with MAOIs can cause a dangerous, potentially life-threatening reaction. Wait at least 14 days after stopping an MAOI.
Pregnancy: Discuss risks and benefits with your provider. Do not stop without consultation.
Questions? I am here.
Reach me between appointments if you have concerns about side effects, notice mood changes, or have questions about your medication.
360-389-3712
info@rootedmindspsychiatry.com