What is Lisdexamfetamine dimesylate? (Overview)
Lisdexamfetamine dimesylate, commonly sold under the brand name Vyvanse®, is a controlled substance used to treat attention deficit hyperactivity disorder (ADHD) in adults and children over the age of 6, as well as moderate to severe binge eating disorder (BED).
This medication is classified as a central nervous system stimulant (CNS) and is only available through prescription from a medical doctor.
Lisdexamfetamine dimesylate works by increasing attention and decreasing restlessness in individuals who are overactive, cannot concentrate for very long, are impulsive or easily distracted. This medication is usually used as part of a more comprehensive treatment plan, which involves social, educational and psychological components too.
It is necessary for this medication to be controlled as it has been known to be addictive for some users (leading to substance abuse). The medication is available as a capsule with a standard starting dose of 30 milligrams per day. Dosages may be gradually increased by a medical doctor to assess at which level an individual is responding best. Dosages may not exceed 70 milligrams per day.
Common side effects with this medication include headache, anxiety, loss of appetite, nausea and or / vomiting, insomnia or problems sleeping, and weight loss.
Further complications can include an increased risk of heart attack, stroke or even sudden death. It is thus very important for you to discuss any medical conditions, or family history of medical conditions with your doctor before accepting a prescription of this drug. Your doctor will need to assess your levels of risk for possible complications before prescribing the medication for treatment purposes.
What is Lisdexamfetamine / Vyvanse used for?
Lisdexamfetamine dimesylate is a stimulant and belongs to a class of drugs known as amphetamines which works by restoring the balance of neurotransmitters (natural chemicals) in the brain.
For those who require treatment for attention deficit hyperactivity disorder (ADHD), Vyvanse helps to increase their ability to pay attention and focus, as well as reduce restlessness (stop fidgeting).
For those with a binge eating disorder (BED), the medication helps a person to significantly reduce the number of binge eating days.
This medication is not recommended for weight loss purposes or the safe treatment of obesity.
Precautions and considerations for taking this medication
Before a medical doctor will consider prescribing this medication they will weigh treatment benefits against any potential health risks, specific to you. Factors that will be taken into consideration include:
- Allergies: An allergy or sensitivity to stimulants can cause adverse reactions or be fatal.
- Age: Paediatric-specific problems can occur for children younger than 6 years of age. Caution is also exercised in seniors who are more likely to have age-related health risks and conditions.
- Pregnancy: Studies for safety are not conclusive at any stage of gestation and may be harmful to the foetus during pregnancy, causing premature labour or low birth weight of the baby.
- Breastfeeding mothers: Studies are not conclusive in determining risk to an infant during breastfeeding by a mother on the medication but the medication may pass through breast milk and cause problems for the baby.
- Medication interactions: Precautions may be necessary if other medications are required to be taken at the same time. It may be necessary to change any other medications you are taking in order for Lisdexamfetamine dimesylate to be safely prescribed. This drug is usually not recommended to be taken at the same time as any other.
- Other medical conditions and problems: Current, a history of or family history of substance abuse, allergy, coronary artery disease, heart disease, heart failure, heart rhythm problems, heart attack, stroke, bipolar disorder, Raynaud’s disease or other blood vessel problems, depression, hypertension or high blood pressure, mania, motor tics, psychosis, seizures, Tourette’s syndrome, and kidney disease.) It is not unusual for this medication to cause blurred vision or make you feel drowsy or dizzy. If any of these symptoms (side effects) occur it is advisable that you do not drive, use machinery or do anything else that can pose a danger to yourself or others until under control. If you or your family and friends notice any unusual changes in your behaviour (increased aggression, hostility, irritability, hallucinations or suicidal thinking and behaviours), you must inform your doctor as soon as possible. The medication can also cause slow growth in children. It is therefore important that your doctor keep track of your child’s height and weight while on the medication.
How to use Lisdexamfetamine dimesylate (Vyvanse)
This medication comes with a guide and it is recommended that you read this with each refill (in case of any ingredient or other changes). Your doctor and or / pharmacist will be able to address all questions you may have.
It is important to follow your doctor’s instructions carefully when taking or administering this medication, and to ensure it is used at the correct dosage (to reduce the risk of potential addiction). He or she will recommend that you take this medication with or without food (swallowed whole), usually in the morning (once daily). If taken during the afternoon or evening, you are likely to experience trouble sleeping.
It is recommended that you swallow the capsule whole. In some cases, an individual may have trouble swallowing. Your doctor may then recommend that you open the capsule, empty its contents (powder) in a glass of water or juice, or alternatively mix with yoghurt, stir well and drink (or eat) once the contents have dissolved (straight away). You may see a filmy coating on the inside of the glass or bowl once you have drunk or eaten the mixture. This is normal.
Your dosage will be based on your overall health and medically assessed condition. Your doctor will also take into account your response to treatment (physically, mentally and emotionally) and adjust accordingly to find the best dose for you. It is important that you openly communicate how you feel your body is responding to treatment with your doctor. If you take the medication for extended periods, you may find it does not work as well. If you notice improvements or worsening of symptoms, your doctor will need to know to adjust your treatment as they feel is best for you.
Your doctor may encourage you to take the medication at the same time each day. The medication typically works best when taken on a regular basis. It can happen that your doctor may recommend that you stop your medication for a short period of time. This can happen if you begin to display changes in your behaviour or show signs of other red flags associated with the use of this medication. If it is determined that you no longer need the medication, your doctor will stop your prescription and gradually reduce your dosage in phases.
It is important not to stop your medication treatment on your own, without your doctor’s knowledge. Withdrawal reactions, especially if it has been used regularly in high doses or for a long period, can happen. These reactions will include severe tiredness, sleep problems, and mood or mental changes.
Lisdexamfetamine dimesylate can interact with other medications, supplements and even herbal mixtures you may be taking. It is strongly advisable to ensure that your doctor is aware of all substances you are taking so that together, you can manage them carefully.
Medications, taken at the same time, that can interact and cause other health problems or complications include:
- Tricyclic antidepressants: These can cause high levels of amphetamine in the brain, resulting in heart problems.
- Monoamine Oxidase Inhibitors (MAOIs): These can increase blood pressure.
- Medications that acidify urine: These types of medications decrease the amount of time lisdexamfetamine dimesylate is able to remain in the body, making it less effective (absorbic acid).
- Medications that alkalinise urine: These types of medications increase the amount of time lisdexamfetamine dimesylate is able to remain in the body, also making the drug less effective by increasing its reaction.
Your doctor will determine your dosage, form and how often you take the medications based on your age, the condition you are requiring treatment for and its severity, other possible medical conditions, as well as your reactions to the first dose.
If you are being treated for attention deficit hyperactivity disorder (ADHD) or binge eating disorder (BED), your doctor will usually prescribe the brand, Vyvanse. This oral capsule comes in 10 milligrams, 20 milligrams, 30 milligrams, 40 milligrams, 50 milligrams, 60 milligrams and 70 milligrams.
ADHD adults (18 – 64 years of age) and children (6 – 17 years of age) will be given a starting dose of 30 milligrams once a day (in the morning) and adjusted as needed until at a dosage that best relieves symptoms.
BED adults (18 – 64 years of age) will be given a starting dose of 30 milligrams once a day (in the morning) and adjusted as needed. Children 17 years of age and younger should not be given this medication.
Adults over 65 tend to process the drug more slowly. A doctor may start seniors (being treated for either condition) on a lower dose to prevent too much of the medication building up in the body, which can be toxic.
If you have a known kidney condition, dosages for either condition, will be adjusted to ensure sufficient kidney function (usually between 30 milligrams and 50 milligrams a day).
It can happen that you miss a dose. If this happens, take it as soon as possible. If it is almost time for your next dose, it is best to rather skip the missed dose and continue with your usual schedule. Doubling doses can cause complications and adverse reactions.
Adverse reactions or unwanted effects can occur and vary from person to person. Many potential problems which arise will need medical attention. Many may not. It is important to consult your doctor as soon as possible if you experience any side effects, especially if they persist or worsen.
Many side effects are merely your body’s way of adjusting to the medication and will stabilise over time. Your doctor will be able to work with you and your treatment dosages to reduce and alleviate side effects which may become bothersome, or prevent them altogether. Your doctor will generally prescribe this medication if its benefits outweigh any risks or side effects.
Common side effects include:
- Decreased appetite
- Upper abdominal pain (stomach)
- Weight loss
Less common side effects include:
- Uncontrolled or repeated vocal outbursts or body movements (tics, twitching or twisting)
- Peeling, blistering or loosening of the skin
- Dizziness or feeling faint
- Difficulties with breathing
- Difficulties with swallowing
- Increased heartbeat or pulse rate (fast, irregular, pounding or racing sensation)
- Depressive symptoms (feeling sad or empty, crying, irritability, agitation, aggression, mood swings, loss of interest or pleasure)
- Hives, welts, skin rashes, red skin lesions, inflammation of the skin or itching and swelling on the face, eyelids, tongue, throat, hands, legs, feet or sex organs
- Joint or muscle pain
- Lack of appetite
- Sore throat
- Sores, ulcers or white spots in the mouth or on the lips
- Swelling in the feet or lower legs
- Tightness in the chest
- Concentration problems
- Sleeping problems
- Dysphoria or euphoria
- Blood flow problems (in the fingers and toes)
- Unusual wounds (on the fingers and toes)
- Frequent or prolonged erections (in males)
It is possible for your blood pressure to increase while on Vyvanse. Your doctor may check this regularly and help to manage any fluctuations.
It is imperative to seek immediate medical assistance if you experience serious side effects such as shortness of breath, sudden vision changes, fainting, seizures, weakness on one side of the body, chest / jaw / left arm pain, serious confusion, slurred speech or an allergic reaction.
Signs of a possible overdose, which will require medical attention as soon as possible include:
- Blurred vision
- Abdominal pain or cramps
- Changes in consciousness or loss of consciousness
- Dizziness / light-headedness or feeling faint
- Dark-coloured urine
- Rapid breathing
- Muscle cramps and spasms
- Muscle pain or stiffness
- Overactive reflexes
- Panic and anxiety
- Pounding sensation in the ears
- Profuse sweating
- Violent outbursts
- Shakiness or trembling in the legs, arms, hands or feet
How long does it take for lisdexamfetamine dimesylate (Vyvanase) to take effect?
Lisdexamfetamine dimesylate (Vyvanse) typically can start working in the body between 2 and 14 hours after taking the medication. A doctor will treat each case individually as a variety of factors will determine the most beneficial dosage.
Is lisdexamfetamine better than adderall?
Adderall (amphetamine and dextroamphetamine) is another medication used to for the clinical treatment of ADHD (attention deficit hyperactivity disorder), as well as narcolepsy. The lisdexamfetamine medication brand that is prescribed is Vyvanse.
Both medications are classified as psycho-stimulants and are made up of amphetamine salts. Vyvanse is made up on one salt (lisdexamfetamine which converts to dextroamphetamine once inside the body) and releases dextroamphetamine at a delayed pace. Adderall is made up of 4 different kinds of salts and releases dextroamphetamine and levoamphetamine instantly into the body.
Vyvanse has been noted to be less likely to result in abuse than Adderall. The body needs to break Vyvanse down before it can have any beneficial effect on the body. Vyvanse cannot be injected or inhaled to get a ‘high’ (a drug induced sense of euphoria).
Both medications have both shown to be effective drugs for the treatment of ADHD. The potential for misuse is significantly lower with Vyvanse. It merely comes down to a matter of choice or preference.