Summary: Vyvanse is a new drug used to treat adolescent ADHD. It does have a lower abuse potential than other drugs in it’s class. But it’s effectiveness in treating ADHD does not appear to be any better, or worse, than other medications in it’s class. Including Adderall XR.
Dear Curtis: My son has always been on Adderall XR and seems to be doing well. His doctor mentioned that a lot more kids are trying Vyvanse. He didn’t recommend a switch but he seems to prefer it over Adderall. I’d like to know what the difference between the two medications really is so we can make a more informed decision?
One of the sad trends that you and I are seeing right now is the increase in abuse of prescription medications. Especially among late elementary to college age students. I mention this because it was really the driving force behind why Vyvanse was developed.
A Quick Chemistry Lesson
You’ve probably heard of Dexedrine. It’s a brand name ADHD (Attention Deficit Hyperactivity Disorder) medication. It’s generic name is dextroamphetamine. Adderall and Adderall XR are actually mixtures of dextroamphetamine (75%) and levoamphetamine (25%).
Vyvanse is actually a drug called lisdexamphetamine. As you can see from the drug name it’s a chemical cousin of dextroamphetamine. In fact, Vyvanse is actually a prodrug of dextroamphetamine.
What that means is that Vyvanse itself has no therapeutic effects in your sons body until it is converted to dextroamphetamine. This is done after he swallows the tablet and it reaches his gastrointestinal tract. Once there the lisdexamphetamine is chemically changed to the active dextroamphetamine.
Because the Vyvanse tablet is ineffective until it reaches his GI tract that means that it is a more difficult to abuse form of ADHD medication, as opposed to Dexedrine and Adderall. In fact, IV (intravenous) abuse of Vyvanse is impossible because it requires conversion in the GI tract which IV use bypasses.
But, that doesn’t mean it’s ‘better’.
Vyvanse Versus Adderall XR
One of the early clinical studies that actually involved Adderall XR and Vyvanse showed that while both drugs are better than placebo (sugar tablets). Vyvanse did not show any clinical improvement over Adderall.
One of the claims to fame of Vyvanse it that because it’s a ‘pure’ form of dextroamphetamine and not a mixture like Adderall XR, then there should be fewer side effects. But, in the real world this hasn’t really proven to be true. And, just like you said with your son, he’s tolerating the Adderall XR just fine.
Considering that, Vyvanse may be a better drug for you son if there are some abuse concerns or if he was having side effects. But, without either of those concerns I really don’t see Vyvanse outperforming Adderall XR in the treatment of your son’s ADHD.