After receiving an attention-deficit/hyperactivity disorder (ADHD) diagnosis, understanding which medications are right for you can feel daunting, and the journey toward finding your answer is often one of trial and error. Medication management is one of the main treatment approaches that mental health professionals will use to improve daily functioning and cognitive performance. Two ADHD medications, in particular, that stand out are lisdexamfetamine - known by the brand name Vyvanse - and amphetamine and dextroamphetamine - known by the brand name Adderall.
Everyone’s ADHD treatment journey is different, and depending on the severity of your symptoms and response to therapy, a psychiatrist may determine that medication is beneficial. As its name suggests, ADHD symptoms include inattention, hyperactivity, and impulsivity. Medication for ADHD may be considered appropriate when these symptoms interfere with daily functioning, relationships, or professional responsibilities, or when attention issues are putting you in dangerous situations, like driving while your mind wanders. Medication can not only help lessen impulsivity, but also give you the ability to ignore urges when they do show up. ADHD is a disorder that involves more than just not being able to focus or being restless. It also contributes to executive dysfunction and cognitive sluggishness - otherwise known as “brain fog” - which makes beginning, continuing, and completing tasks difficult.
Adderall and Vyvanse are drugs used by many children and adults to treat attention deficit hyperactivity disorder (ADHD). Both are stimulants called amphetamines. They work by raising levels of chemicals in your brain called dopamine and norepinephrine that help you focus, control your impulses, and pay attention at school or work. About 80% of people notice that their symptoms are better when they take stimulants. Vyvanse and Adderall aren't exactly the same, though. They do different things in your body and can cause different side effects. You'll work with your doctor to find an ADHD treatment that's best for you. It might take some time to find the right medicine and dose. If the first one your doctor prescribes doesn't work, you can try a different one.
What are Adderall and Vyvanse?
Adderall is the brand name for a mix of two stimulants called amphetamine-dextroamphetamine. It comes in a capsule full of beads that hold these medicines, which are also called mixed amphetamine salts. A capsule of Adderall can contain between 5 and 30 milligrams of the medicine. A dose of the original form lasts about 4 hours in your body. The longer-acting form, called Adderall XR, comes in the same sizes but can last 8-12 hours. This is because half the beads are fast-acting, and the others are slow-acting.
Vyvanse is the brand name for lisdexamfetamine dimesylate. It comes in capsules, with 10-70 milligrams of medicine, and chewable tablets, with 10-60 milligrams of medicine. It also has the stimulant amphetamine but adds a compound called lysine.
Read also: Weight Loss with Adderall: What You Need to Know
Adderall is a combination drug that includes levoamphetamine and dextroamphetamine. It’s part of a class of drugs known as stimulants. Vyvanse, which has the generic name lisdexamfetamine, is also a stimulant of the central nervous system.
How do Adderall and Vyvanse Work?
Adderall combines dextroamphetamine and amphetamine, stimulating the central nervous system. The medication increases dopamine and norepinephrine levels in the brain, which improves attention, focus, and behavioral control. Doctors prescribe Adderall at various dosages based on age, symptom severity, and individual response. The immediate-release version requires multiple daily doses while the extended-release formula provides all-day coverage with a single morning dose.
Your body has to absorb the lysine to get to the stimulant, so your dose may last up to 14 hours. In some cases, your doctor might suggest you combine long-acting and short-acting stimulants to get full coverage during the day - for example, taking a long-acting dose early in the morning and a short-acting dose in the afternoon.
Vyvanse contains lisdexamfetamine, a prodrug that remains inactive until the body metabolizes it in the digestive system. The liver converts lisdexamfetamine and dextroamphetamine, increasing dopamine and norepinephrine levels in the brain. The FDA approved Vyvanse for ADHD treatment in children, adolescents, and adults. Doctors also prescribe it for moderate to severe binge eating disorder in adults.
Vyvanse is a stimulant medication that can provide steady, all-day ADHD symptom management with a single dose, typically taken in the morning. Vyvanse is a prodrug, which means it remains inactive until your body metabolizes it, which can take about an hour and will last anywhere from 10 to 14 hours. It’s an extended release option, so the onset and offset of the medication is typically gradual and well-tolerated, helping reduce the likelihood of a “crash” once it’s left your system.
Read also: Does Adderall Help You Lose Weight?
Key Differences Between Adderall and Vyvanse
Adderall and Vyvanse share several fundamental characteristics despite their different formulations.
- Activation method: Adderall activates immediately upon absorption.
- Onset time: Adderall begins working within 30 minutes.
- Duration: Adderall IR lasts four to six hours while Adderall XR lasts about 10 to 12 hours.
- Dosing options: Adderall offers immediate and extended-release options.
- Approved uses: Vyvanse has FDA approval for moderate to severe binge eating disorder in addition to ADHD.
- Release pattern: Adderall may create more noticeable peaks and valleys in symptom control.
- Available formulations: Adderall comes in tablets.
- Generic availability: Generic versions of Adderall exist.
The key differences between Adderall and Vyvanse are that Vyvanse stays active in your body longer than Adderall and Adderall XR. Vyvanse also has a lower abuse potential and may be a better choice for anyone with a history of substance abuse.
Here's a table summarizing the differences between Vyvanse and Adderall:
| Feature | Vyvanse | Adderall (Immediate Release) | Adderall XR (Extended-Release) |
|---|---|---|---|
| Active ingredient | Lisdexamfetamine | Amphetamine/dextroamphetamine | Amphetamine/dextroamphetamine |
| How long to start working | 1 to 2 hours | Immediately | Immediately |
| Duration | Up to 14 hours | Up to 4 hours | Up to 12 Hours |
| Times taken per day | Once | 2-3 times | Once |
| Abuse potential | Medium | High | High |
| FDA approved | 2007 | 1996 | 2002 |
Side Effects of Adderall and Vyvanse
Because Adderall and Vyvanse are both stimulants, they have similar side effects. Any stimulant can cause side effects like:
- Headaches
- Dizziness
- Dry mouth
- Higher blood pressure
- Stomach upset or pain
Anyone who has a heart problem shouldn't take stimulants. And if you have psychosis, bipolar disorder, aggression, or seizures, these medications can make your symptoms worse. They also can cause blurred vision.
Read also: The Truth About Adderall, Weight Loss, and Weight Gain
Adderall and Vyvanse share the most common side effects due to their similar mechanisms of action.
- Intensity timing: Adderall may cause more intense initial side effects that diminish more quickly.
- Sleep disturbances: Adderall may cause more sleep difficulties if taken later in the day.
- Mood changes: Adderall sometimes creates more noticeable mood fluctuations as levels rise and fall.
- Crash symptoms: Some people experience more pronounced “crashes” as Adderall wears off.
Here's a more detailed list of potential side effects:
Common side effects of Vyvanse and Adderall:
| Vyvanse | Adderall and Adderall XR |
|---|---|
| Upper belly pain | Stomachache |
| Dizziness | Decreased appetite |
| Irritability | Nervousness |
| Nausea | Dry mouth (Adderall XR) |
| Weight loss | Loss of appetite (Adderall XR) |
| Decreased appetite | Trouble sleeping (Adderall XR) |
| Dry mouth | Headache (Adderall XR) |
| Trouble sleeping | Weight loss (Adderall XR) |
| Vomiting | Nausea (Adderall XR) |
| Anxiety (Adderall XR) | |
| Agitation (Adderall XR) | |
| Dizziness (Adderall XR) | |
| Fast heartbeat (Adderall XR) | |
| Diarrhea (Adderall XR) | |
| Weakness (Adderall XR) | |
| Urinary tract infections (UTIs) (Adderall XR) |
Other possible side effects of both Adderall and Vyvanse include:
- Anxiety or the jitters
- Insomnia
- Stomach pain
- Loss of appetite
- Irritability
- Vomiting
- Mood swings
- Skin rash
- Restlessness
- Tremors
- Tics
- Diarrhea
- Constipation
- Weight loss
- Crankiness
- Hives
- Skin rash
More rarely, you might have a faster heart rate, heart palpitations, or tremors.
Serious side effects of Adderall and Vyvanse:
| Vyvanse | Adderall and Adderall XR |
|---|---|
| Heart-related problems due to it being a stimulant medication | Heart-related problems due to it being a stimulant medication |
| Mental/psychiatric problems | Mental/psychiatric problems |
| Slowing of growth (height and weight) in children | Slowing of growth (height and weight) in children |
| Seizures, mainly in patients with a history of seizures | Seizures, mainly in patients with a history of seizures |
| Eyesight changes or blurred vision | Circulatory problems in fingers and toes |
| New or worsening tics or worsening Tourette’s syndrome | Serotonin syndrome |
| New or worsening tics or worsening Tourette’s syndrome |
If you have serious side effects, contact your medical provider immediately. If you have a medical emergency, go to the emergency room, or call 911.
Sexual Side Effects
With Adderall, some men may have changes in erections, including trouble getting or maintaining them, more frequent erections, or erections that last longer than normal. Sexual side effects, including erection problems and reduced interest in sex, were reported by 2%-4% of adults getting Adderall XR in a clinical trial.
About 2% of men in Vyvanse studies reported erectile dysfunction. Just over 1% of all adults reported a reduced interest in sex.
Drug Interactions
Vyvanse and Adderall may have adverse effects when taken with other medications or substances. Drug interactions can also increase the risk of serious side effects. In some cases, drug interactions can decrease the effectiveness of your medications. Common drug interactions that can occur with both Vyvanse and Adderall include:
- Monoamine oxidase inhibitors (MAOIs): Taking a stimulant with an MAOI can cause a potentially fatal interaction.
- Ecstasy: Taking it with Vyvanse or Adderall can lead to serotonin syndrome, which is a serious life-threatening condition that results from too much serotonin.
- Antidepressants: Taking some antidepressants with Vyvanse or Adderall can increase the risk of serotonin syndrome, including Prozac (Fluoxetine), Zoloft (sertraline), Cymbalta (duloxetine), Pamelor (nortriptyline), and others.
- Lithium: Taking Lithium, which is used to treat bipolar disorder, with Vyvanse or Adderall increases the risk of serotonin syndrome.
One difference: research suggests that proton pump inhibitors, used to treat heartburn, don't interfere with Vyvanse but do slow down the time it takes Adderall XR levels to rise in the blood.
Adderall vs. Vyvanse: Effects on Weight Loss
A common side effect of both Adderall and Vyvanse is appetite suppression, which can cause weight loss. However, whether Adderall or Vyvanse will cause more weight loss depends on several factors, including your individual response to stimulant medications, your metabolism and eating habits, and the length of treatment. Additionally, Adderall XR and Vyvanse may have a higher potential for weight loss due to their longer duration.
Using Adderall or Vyvanse for weight loss isn’t an approved use. Amphetamines like Adderall can lead to weight loss. Vyvanse acts similarly to an amphetamine. These drugs release certain brain chemicals that can increase energy and suppress appetite. Both tend to have similar weight loss results, but with Adderall people may experience rebound hunger after the effects of the drug wear off.
When the effects of either medicine wear off, so does the appetite suppression. Your body also quickly adjusts to the medicine’s effects, so you may no longer experience appetite suppression after a short period of taking them. This makes the weight loss effects both short-lived and unsustainable for most people. What’s more, when you’re withdrawing from amphetamines, the result is an increased appetite. For example, you may have extreme changes in mood, intense anxiety, or severe insomnia.
Finally, when people are coming down off Adderall or Vyvanse, it can cause them to feel depressed or have sudden shifts in mood. Feelings of depression or anxiety can lead to suicidal thinking.
Amphetamines like Adderall and Vyvanse can reduce appetite and lead to weight loss. In children, they may slow growth.
Other Considerations
Cost and Availability
The cost of any drug can vary widely based on the form and dosage. And pharmacies can have different prices for the drugs, too. Check with your insurance plan to see what's covered. In general, generics can cost much less than brand names. In the past, Vyvanse was only available as a name-brand prescription drug, which often kept its price higher than alternative medicines, but it's now available in generic form as well. Adderall and Adderall XR are available as generic medicines, which can help control their cost. In some cases, insurers might not pay for the brand name drugs because a generic version is available.
Drug shortages have at times affected the cost and availability of Adderall and other stimulant drugs in recent years. Stimulants are considered controlled substances, which means they have the potential to be misused and to lead to substance use disorders, including addiction. Some states limit the supply you can buy at one time for that reason.
According to the FDA drug shortage database, there are currently shortages of many stimulant ADHD medications, including all forms of Vyvanse. It’s either unavailable or in short supply from most pharmaceutical companies. There’s also an Adderall shortage.
Abuse Potential
While it's possible to abuse or start to depend on any stimulant, that may be less likely with Adderall XR and Vyvanse because they're designed to release their active chemicals slowly. That's especially true for Vyvanse because your body has to process the lysine before it gets to the stimulant part of the drug. But you and your doctor or your child's doctor should discuss the full risks and benefits of various treatment choices before deciding what's best.
Vyvanse and Adderall have an FDA-boxed warning for the risk of misuse and dependence. This is the strongest warning issued by the FDA. If you take these medications other than how prescribed, this increases the risk. Misusing these drugs can also lead to overdose and sudden death.
Both Adderall and Vyvanse can contribute to abuse and addiction, as well as physical dependence.
Efficacy
Studies comparing the drugs are limited. One analysis of 20 studies found that in adults, ADHD symptoms improved significantly with either lisdexamfetamine (Vyvanse) or mixed amphetamine salts (Adderall), but the effects were somewhat stronger with Vyvanse. It's best to talk with your doctor about the best medication choice for you or your child. For example, school-age children often need shorter-acting medicines so that they can get enough sleep and Vyvanse doesn't come in a short-acting form.
A study, published in the Journal of Central Nervous System Disease, found that people who took longer-acting stimulants like Vyvanse were more likely to be medication-compliant compared to those taking other ADHD medications. That’s because of the once-daily dosing, according to the study authors. Otherwise, both drugs are similarly effective in treating all types of ADHD.
A meta-analysis conducted by researchers at Harvard Medical School looked at the effectiveness of standard-release Adderall for ADHD across 6 studies. This analysis found that Adderall is effective for hyperactivity, inattention, aggression, and impulsivity in children and adults.
Vyvanse has also been shown to be effective for the treatment of ADHD. A review of several studies examined the effectiveness of Vyvanse compared to placebo for ADHD in adults 18 to 55. Participants who were taking Vyvanse had significant improvements in ADHD symptoms compared to placebo.
Alternatives to Adderall and Vyvanse
In addition to Vyvanse, Adderall, and their generic versions, other stimulant drugs on the market include forms of methylphenidate, such as Ritalin and Concerta, which are not amphetamines but work in similar ways. Additional amphetamines used for ADHD include forms of dextroamphetamine, such as Dexedrine, as well as medicines called amphetamine sulfates. Some stimulant medicines are used to treat conditions such as binge eating disorder, obesity and narcolepsy, a sleep disorder, as well as ADHD.
Non-stimulant drugs and non-drug therapies can also be part of ADHD treatment.
What Type of ADHD is Vyvanse Best For?
Vyvanse is approved for treating ADHD in adults and children aged 6 years and older. It was tested and found effective in people with all types of ADHD, including those with hyperactivity and impulsiveness alone, inattention alone, or combined symptoms.
What's the Strongest ADHD Medication?
Amphetamine medications like Adderall and Vyvanse can have a somewhat stronger effect on your brain chemicals than non-amphetamine stimulants like Ritalin and Concerta. But that doesn't necessarily make them better choices. You want a medication that gives you ideal levels of the brain chemicals that help you focus. Getting too much of a boost could make your symptoms worse. So choosing the right medicine at the right dose can be a matter of trial and error.