Vyvanse vs. Adderall

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

ADHD in Adults: Diagnosis, Treatment

Vyvanse vs. Adderall comparison facts

Adderall and Vyvanse are amphetamines, which are stimulants that increase the level of important chemical messengers (neurotransmitters) in the brain. Amphetamines are used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy. Vyvanse is approved to treat these disorders as well as moderate-to-severe binge eating disorder.

The difference between the drugs is that Adderall contains amphetamine salts (amphetamine and dextroamphetamine), whereas Vyvanse contains lisdexamfetamine, which the body converts to dextroamphetamine before it is active.

The side effects of Adderall and Vyvanse are similar, and include

  • Insomnia,
  • Anxiety,
  • Decreased appetite, and others.

Both drugs may cause priapism, which is a penile erection lasting more than four hours that can damage the genital tissue.

Vyvanse and Adderall should not be taken with monoamine oxidase (MAO) inhibitor drugs including phenelzine (Nardil), tranylcypromine (Parnate), and Zyvox. Use of amphetamines within 14 days of using MAO inhibitor drugs should be avoided. Patients receiving antihypertensive medications may experience loss of blood pressure control when using amphetamines.

What are Vyvanse and Adderall prescribed for?

Vyvanse is used for the treatment of attention deficit hyperactivity disorder (ADHD), and moderate to severe binge eating disorder.

Adderall is used for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. Adderall XR is only approved for treatment of ADHD.

Quick GuideADHD/ADD in Adults: Symptoms & Treatments in Pictures

ADHD/ADD in Adults: Symptoms & Treatments in Pictures

Vyvanse vs. Adderall dosage

Vyvanse

The recommended starting dose of Vyvanse for treating ADHD in adults is 30 mg and for pediatric patients ages (6-12) it is 20 to 30 mg once daily in the morning. Doses may be increased by 10-20 mg/day at weekly intervals. The maximum dose is 70 mg daily. The recommended dose for treating binge eating in adult is 50 to 70 mg daily. The starting dose is 30 mg/day and the dose is gradually increased by 20 mg at weekly intervals to reach the recommended daily dose.

Adderall

Adderall usually is taken once or twice a day. Doses should be separated by at least 4-6 hours. The recommended dose is 2.5 to 60 mg daily depending on the patient's age and the condition being treated. Adderall XR is taken once daily. The recommended dose is 5-40 mg daily administered in the morning. The entire contents of the Adderall XR capsules may be sprinkled into applesauce and consumed immediately. Amphetamines should be administered during waking hours and late evening doses should be avoided in order to avoid insomnia.

Side effects of Vyvanse and Adderall

Vyvanse

Common side effects of Vyvanse include:

Other important side effects of Vyvanse include:

Increased blood pressure, sudden death in patients with heart problems, strokes, and heart attacks have been associated with Vyvanse. Patients may experience new or worsening of psychiatric symptoms (for example, manic episodes, hearing voices, hallucinations) or worsening of aggressive behavior or hostility.

Adderall

Side effects of amphetamines include excessive stimulation of the nervous system leading to:

Blood pressure and heart rate may increase, and patients may experience palpitations of the heart.

Other important side effects include:

Priapism is a risk that comes with both Adderall and Vyvanse. The condition is defined as painful or painless penile erection lasting more than 4 hours, have been reported in pediatric and adult patients treated with stimulants. The erection usually resolves when the drug is stopped. Prompt medical attention is required in the event of suspected priapism.

Both Adderall and Vyvanse, like other amphetamines, may be abused. Amphetamines have been associated with tolerance, psychological dependence, and social disability. Stopping amphetamines suddenly may cause a withdrawal syndrome that includes extreme fatigue and mental depression. Therefore, their use should be discontinued by slowly reducing the dose.

Drug interactions with Vyvanse vs. Adderall

Vyvanse

Monoamine oxidase inhibitor (MAOIs) antidepressants such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), selegiline (Eldepryl) and procarbazine (Matulane), slow the elimination of amphetamines in the body. This increases the concentration of amphetamines and their effect. This can cause serious elevations in blood pressure (hypertensive crisis) with headaches, other signs of hypertensive crisis, and even fatal reactions. Vyvanse should not be administered until 14 days after MAOIs have been discontinued in order to allow the effects of the MAOIs to dissipate. Amphetamines increase the effect of norepinephrine. Combining both drugs may lead to seriouscardiovascular toxicity.

Adderall

As with Vyvanse, Adderall should not be taken with monoamine oxidase (MAO) inhibitor drugs including phenelzine (Nardil), tranylcypromine (Parnate), and Zyvox; use of amphetamine within 14 days of using MAO inhibitor drugs should be avoided. Patients receiving antihypertensive medications may experience loss of blood pressure control with amphetamine. Antacids may increase absorption of amphetamine salts and increase their effectiveness and side effects.

Pregnancy and breastfeeding safety for Vyvanse vs. Adderall

Vyvanse

There are no adequate studies of Vyvanse in pregnant women. Amphetamines may cause premature delivery, low birth weight, and withdrawal symptoms in infants born to mothers who are dependent on amphetamines.

Amphetamines are excreted in breast milk. Mothers taking amphetamines should not breastfeed.

Adderall

As with Vyvanse, Adderall should not be used during pregnancy. Infants who are born to mothers dependent on amphetamines exhibit symptoms of withdrawal and have an increased risk of low birth weight.

Mothers taking amphetamines should refrain from nursing their infants because these drugs are excreted in human milk and can have undesirable effects on the child.

FDA Prescribing Information

Last Editorial Review: 11/14/2016

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Reviewed on 11/14/2016
References
FDA Prescribing Information

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