VYVANSE

DESCRIPTION / DEFINITIONS: Vyvanse® is an amphetamine, a central nervous system (CNS) stimulant. It is prescribed for the set of symptoms known as Attention Deficit Hyperactivity Disorder (ADHD) and for moderate to severe Binge Eating Disorder (BED). It is also used off-label as a study drug and for several other conditions. See more information below. 

ABUSE: Vyvanse has a high potential for abuse and dependence, according to a boxed warning from the Food and Drug Administration (FDA). See more information below.

ADDICTION / DEPENDENCE: As with other CNS stimulants, Vyvanse has a high potential for addiction and dependence.  See more below, including half life and metabolism.

SIDE EFFECTS:  Blisters, rashes, mania and insomnia are just a few of the side effects. See more complete list below.

WITHDRAWAL SYMPTOMS: Among the withdrawal symptoms are extreme fatigue, depression, hallucinations, severe agitation and aggressiveness, extreme paranoia, and chest pains. See more on the list below.

TREATMENT: Treatment is dependent on how long you have been taking the drug, at what dose and frequency, as well as on your individual reaction to the drug and to quitting.

 

Vyvanse contains lisdexamfetamine, which metabolizes into amphetamine, a central nervous system (CNS) stimulant. The Drug Enforcement Administration (DEA) has designated Vyvanse as a Schedule II drug.

Vyvanse was developed by New River Pharmaceuticals and approved by the FDA in 2008 for ADHD. It was a substitute for dextroamphetamine (such as Adderall and Dexedrine) and intended to be longer-lasting and less abused. 

The FDA also approved Vyvanse for binge eating disorder (BED).

Vyvanse is also prescribed off-label – which means it’s being prescribed at a doctor’s discretion for a type of patient or condition for which it has not been tested for safety or efficacy – for a number of conditions and uses, including as a study drug, for Asperger syndrome, chronic fatigue syndrome, depression, narcolepsy, and oppositional defiant disorder (OPP). OPP is diagnosed by a set of symptoms – physical aggression, verbal abuse, explosions of anger, deliberately annoying others, vindictive behavior, frequent arguments, defiance of rules and laws – present for at least six months.

 

Vyvanse is still abused despite it being approved on the basis that it would be less abused than Adderall or similar drugs. While it’s true that, unlike Adderall, Vyvanse is activated by digestion and therefore you cannot get high by crushing and snorting or injecting it, Vyvanse can still be abused by taking higher doses than prescribed and is easily susceptible to dependence and addiction.

It is also sold by drug dealers or gotten from friends as a study drug and simply to get high.

 

The FDA issued a black box warning to be on every Vyvanse label:

WARNING: ABUSE AND DEPENDENCE

CNS stimulants (amphetamines and methylphenidate-containing products), including VYVANSE, have a high potential for abuse and dependence. Assess the risk of abuse prior to prescribing and monitor for signs of abuse and dependence while on therapy.

Of course, when people are getting the drug from their friends or from drug dealers, they are not going to be monitored for signs of abuse or dependence, so they could become addicts without anyone realizing it.

Half-Life and Metabolism

The biological half life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

Vyvanse lasts longer than other drugs. The half-life is approximately 12 hours.

Metabolism

Lisdexamfetamine is converted to dextroamphetamine and l-lysine primarily in blood due to the hydrolytic activity of red blood cells after oral administration of lisdexamfetamine dimesylate. In vitro data demonstrated that red blood cells have a high capacity for metabolism of lisdexamfetamine. Lisdexamfetamine is not metabolized by cytochrome P450 enzymes.

 

Anyone sensitive or allergic to lisdexamfetamine, amphetamine, or any of the inactive ingredients in the capsules or chewable tablets could experience a reaction.

The following side effect information is taken from the Vyvanse label:

  • abdominal pain (upper)
  • affect lability – exaggerated changes in mood or emotions in quick succession
  • agitation
  • anorexia
  • anxiety
  • constipation
  • decreased appetite
  • decreased libido
  • decreased weight
  • diarrhea 
  • dizziness
  • dry Mouth
  • dyspnea – difficult or labored breathing
  • energy Increased
  • erectile dysfunction
  • feeling Jittery
  • gastroenteritis
  • hyperhidrosis – excessive sweating of the palms, soles, groin, face or head, and armpits. May be an indication of underlying health problems, or a side effect of drugs.
  • increased blood  pressure
  • increased heart rate
  • insomnia
  • irritability
  • nausea
  • nightmare
  • oropharyngeal Pain 
  • paresthesia 
  • pruritis 
  • pyrexia
  • rash
  • restlessness
  • somnolence
  • tic
  • tremor
  • urinary tract infection
  • vomiting

 

After Vyvanse was approved by the FDA and started being sold, additional side effects were reported. They include:

  • aggression
  • anaphylactic reaction – anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death. It typically causes more than one of the following: an itchy rash, throat or tongue swelling, shortness of breath, vomiting, lightheadedness, and low blood pressure, and hypersensitivity
  • angioedema – a condition similar to hives but the welts, which can be tiny or several inches, are under the skin
  • blurred vision
  • bruxism – unconsciously grinding, gnashing or clenching your teeth whether asleep or awake 
  • cardiomyopathy – a disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body. Cardiomyopathy can lead to heart failure.
  • constipation
  • depression
  • dermatillomania – compulsively picking at scabs, scars and other parts of the skin
  • difficulties with visual focus
  • diplopia – double vision
  • dyskinesia – involuntary, abnormal, uncontrolled movement
  • priapism – frequent or prolonged painful erections, in adults or children, that could cause permanent damage
  • hepatitis
  • libido changes
  • mydriasis – also known as a blown pupil, a long-lasting dilation of the pupil. It should be checked out by a doctor as it can be associated with stroke, impending brain herniation, epilepsy
  • palpitations
  • rhabdomyolysis – a rare and painful condition that causes muscle cells to break down
  • seizures
  • Stevens-Johnson Syndrome – a serious adverse reaction of the skin and mucous membranes. Signs and symptoms include blisters, rash and skin pain.
  • tics
  • urticaria – a kind of skin rash with red, raised, itchy bumps. They may also burn or sting.

 

WITHDRAWAL SYMPTOMS

Quitting Vyvanse can be very difficult. Patients who suddenly change or stop their dose of Vyvanse may experience symptoms such as:

  • blurred vision
  • extreme paranoia
  • fevers
  • hallucinations
  • insomnia
  • muscle pain
  • nausea
  • nervous tics
  • nervousness
  • rapid heart rates
  • seizures
  • severe agitation or aggressiveness
  • severe craving for Vyvanse
  • severe headaches or migraines
  • shortness of breath
  • tremors
  • vomiting

 

As with other study drugs, amphetamines, and other central nervous system stimulants, treatment depends on how much of the drug you’ve been taking, the dosage, the frequency, and how you react to the drug and to quitting. In any case, withdrawal should be medically supervised. Quitting may be best done by gradually decreasing the dosage, or medical detox may be called for if the effects of quitting are too painful or uncomfortable mentally or physically.