Home What is Adult ADD? Does ADD Exist? ADD Questionnaire How I treat ADD Questions / Answers Psych/Neuro Tests Vyvanse Adderall vs Ritalin High Dose Stimulants Coaching Gems Research on ADD Reminder System ADD and Psychotherapy Getting Help Nick Schwartz, MD Marc Schwartz, MD Info for Clinicians

VyvanseTM

Vyvanse is dextroamphetamine (brand names Dexedrine, Dextrostat, etc) that uses an unusual delivery system to get into a person's blood stream.  How the new system was developed is interesting. 

The more rapidly a stimulant gets into the blood stream, the higher and more excited, even high, a person can get on it.  For most people, taking a stimulant by mouth gets medication into their blood stream fairly slowly, so few people get high on it.  But some people grind up these medications, then sniff them or inject them into their veins.  They got high, but they also can quickly became addicted and some have died of overdose.  Scientists have searched for a way to prevent this from happening.

A few years ago, someone invented a process that makes medications inactive by attaching the amino acid lysine to them.   If someone grinds up the medication attached to the lysine and sniffs or injects it, they would not get high.  But if someone swallows it, intestinal enzymes break the bond between the medication and the lysine, and the medication becomes active.

Vyvanse is dextroamphetamine attached to lysine.  When a Vyvanse pill is swallowed, the dextroamphetamine is slowly freed from the lysine and seeps into the blood stream.   An unexpected benefit of this system is that the dextroamphetamine gets into the blood stream very steadily and over a period of ten hours or so after it is taken.   This means it acts over a longer period of time than do other long acting ADD medications.  In my experience, it also appears to have a slightly stronger effect than Adderall, which in turn has a slightly stronger effect than Ritalin or Concerta for many people.  For these reasons, it is usually my first choice of medications to treat ADD.

The major downside of Vyvanse is that it is expensive.  If your insurance covers all but a small co-pay, that may not be an issue.  But some insurance companies require a larger co-pay for Vyvanse than for other stimulants, and some people don't have medication insurance coverage.  In addition, because it is more expensive, some insurance companies require that the prescribing clinician submit a prior authorization request justifying its use and dosage.

For more information about Vyvanse dosing, click here.  For information about stimulant medications, click here.

What is Adult ADD? Does ADD Exist? ADD Questionnaire How I treat ADD Questions / Answers Psych/Neuro Tests Vyvanse Adderall vs Ritalin High Dose Stimulants Coaching Gems Research on ADD Reminder System ADD and Psychotherapy Getting Help Nick Schwartz, MD Marc Schwartz, MD Info for Clinicians