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Vyvanse vs Dexedrine
Introduction
For patients with Attention Deficit Hyperactivity Disorder (ADHD) or narcolepsy, certain stimulant medications that alter the concentrations of compounds in the brain related to focus and attention can help manage symptoms. Vyvanse and Dexedrine are two such drugs commonly prescribed for these conditions. Both medicines impact similar neurotransmitters in the brain but have different delivery mechanisms and durations of effect. Vyvanse is a prodrug form of dextroamphetamine coupled with an amino acid, which requires metabolization by the body's enzymes before it becomes active, providing a more gradual onset and longer duration of action. On the other hand, Dexedrine contains dextroamphetamine in its direct form and starts working sooner after ingestion but has a shorter duration compared to Vyvanse.
Vyvanse vs Dexedrine Side By Side
| Attribute | Vyvanse | Dexedrine |
|---|---|---|
| Brand Name | Vyvanse | Dexedrine |
| Contraindications | Should not be taken with MAO inhibitors or within 2 weeks of stopping such medications. May worsen symptoms of anxiety or agitation. | Should not be taken with MAO inhibitors or within 2 weeks of stopping such medications. May worsen symptoms of anxiety or agitation. |
| Cost | For the brand name, around $380 for 30 capsules (50 mg). Generic versions, if available, range from about $11 to $13 per day. | For the brand name, approximately $420 for 60 tablets (10 mg). Generic dextroamphetamine is more affordable, with costs ranging from about $0.25/day to around $1/day. |
| Generic Name | Lisdexamfetamine | Dextroamphetamine |
| Most Serious Side Effect | Increased heart rate or palpitations, signs of an allergic reaction, vision changes, neurological symptoms, low sodium levels, severe nervous system reactions, symptoms mimicking serotonin syndrome. | Allergic reactions, mood swings or behavior changes, hallucinations, chest pain, unexplained wounds, numbness in hands or feet, muscle twitches, vision changes. |
| Severe Drug Interactions | MAO inhibitors, certain antidepressants, and blood pressure medicines. | MAO inhibitors, certain antidepressants, and blood pressure medicines. |
| Typical Dose | 20-70 mg/day for ADHD, starting at 30 mg/day. | Starting dose of 5-10 mg/day for adults and 2.5–5 mg per day for children, with a maximum daily dosage around 40 mg for adults and 20-25 mg for children. |
What is Vyvanse?
Lisdexamfetamine (the generic name for Vyvanse) was a significant development in the class of stimulant medications that also includes drugs like Dexedrine. Lisdexamfetamine was first approved by the FDA in 2007. Unlike Dexedrine, which is an immediate-release formulation, Vyvanse has a unique delivery system that gradually releases dextroamphetamine into the body throughout the day. It is prescribed for both children and adults diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and it's also been approved to treat Binge Eating Disorder in adults. With its selective influence on norepinephrine and dopamine, it results in having fewer side effects than other stimulants that have stronger effects on these neurotransmitters.
What conditions is Vyvanse approved to treat?
Vyvanse is approved for the management of several conditions:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Moderate to severe Binge Eating Disorder in adults While Dexedrine also treats ADHD, it does not have approval for use in managing binge eating disorders.
How does Vyvanse help with these illnesses?
Vyvanse helps to manage Attention Deficit Hyperactivity Disorder (ADHD) by increasing the amount of dopamine and norepinephrine between the synapses of the brain. It does this by blocking their reabsorption into neurons, hence allowing these neurotransmitters to be available for longer periods. Dopamine and norepinephrine are neurotransmitters that play crucial roles in attention, focus, impulse control, and activity level regulation — aspects usually affected in ADHD patients. It is believed that individuals with ADHD have relatively lower levels of these neurotransmitters. Therefore, by elevating dopamine and norepinephrine levels, Vyvanse can limit the negative effects associated with ADHD and help patients better manage their condition.
Dexedrine works similarly as it also increases dopamine and norepinephrine availability within synaptic gaps; however, its absorption rate differs from Vyvanse's which may lead to differences in duration of action or side-effect profile.
What is Dexedrine?
Dexedrine is a brand name for dextroamphetamine, which is a central nervous system stimulant that enhances the levels of norepinephrine and dopamine in the brain by reducing their reuptake. This increase in neurotransmitters can lead to heightened concentration and focus, reduced fatigue, and improved mood - effects beneficial for treating conditions like attention-deficit hyperactivity disorder (ADHD) and narcolepsy. Dexedrine was first approved by the FDA in 1976.
Unlike Vyvanse (lisdexamfetamine), Dexedrine does not need to be metabolized into its active form in the body. This means it starts working faster than Vyvanse but also has a shorter duration of action. Its side effect profile differs from Vyvanse as well; side effects may include restlessness or tremor, insomnia, headache or changes in sex drive or ability. Despite these potential side effects, many patients respond well to Dexedrine when other ADHD medications are ineffective.
What conditions is Dexedrine approved to treat?
Dexedrine is an approved medication for the treatment of:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Narcolepsy, a chronic sleep disorder characterized by excessive daytime drowsiness and sudden attacks of sleep.
How does Dexedrine help with these illnesses?
Dopamine is a neurotransmitter that plays multiple roles in the body, including regulating mood and reward-driven behavior. It's also crucial for motor functions, memory storage, focus, and concentration. Just like norepinephrine and serotonin, low levels of dopamine are associated with conditions such as ADHD (Attention Deficit Hyperactivity Disorder) and depression. Dexedrine works by increasing the levels of dopamine available in the brain which can help to improve attention span and decrease impulsivity in individuals with ADHD. This mechanism makes it different from Vyvanse which needs to be broken down in the body first before it becomes effective. Since Dexedrine has a direct effect on dopamine levels without needing metabolic conversion like Vyvanse does, it may sometimes be prescribed when a patient does not respond well to other stimulant medications or may be combined with them.
How effective are both Vyvanse and Dexedrine?
Both lisdexamfetamine (Vyvanse) and dextroamphetamine (Dexedrine) are powerful central nervous system stimulants, widely used in the management of Attention Deficit Hyperactivity Disorder (ADHD). They were both approved by the FDA, with Dexedrine being an older drug introduced in 1976 and Vyvanse more recently in 2007. Both medications work by increasing levels of certain neurotransmitters in the brain that help with focus, attention, and impulse control.
Their effectiveness was directly compared in a randomized controlled trial conducted in 2015; both drugs exhibited similar efficacy levels for managing symptoms of ADHD. However, each has different pharmacokinetics: Vyvanse is a prodrug that needs to be metabolized into active dextroamphetamine whereas Dexedrine is instantaneously active upon intake.
A meta-analysis from 2013 demonstrated that Vyvanse starts alleviating ADHD symptoms within two hours post-dosing and lasts longer than other stimulant medications—up to fourteen hours—which makes it particularly useful for people needing extended symptom relief throughout their day. The same review noted its lower potential for abuse due to its prodrug status which requires metabolic conversion into an active form.
On the other hand, Dexedrine has been found effective not only against ADHD but also narcolepsy. It may be considered first-line treatment based on individual patient circumstances such as cost considerations or rapid onset requirements due to its immediate action profile compared to Vyvanse's delayed-action profile.
Like all amphetamines, however, both can cause side effects including elevated heart rate/blood pressure or anxiety/irritability among others so they should always be taken under close medical supervision.
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At what dose is Vyvanse typically prescribed?
Oral dosages of Vyvanse range from 20-70 mg/day for treating attention deficit hyperactivity disorder (ADHD) in adults and children aged six and older. A typical starting dose is 30 mg/day, but a doctor may adjust this after observing the patient's response over several weeks. For Dexedrine, oral doses for ADHD treatment also vary widely depending on age and circumstance – with initial daily doses typically around 5-10 mg for adults or children aged six or older - to be taken once or twice daily. However, it's important to remember that these medications should always be used under the guidance of a healthcare professional who can monitor their effects closely due to the risk of dependency associated with stimulant drugs. The maximum dosage that should not be exceeded in any case is 70mg/day for Vyvanse and 40mg/day for Dexedrine.
At what dose is Dexedrine typically prescribed?
Dexedrine treatment typically commences with a dosage of 5-10 mg/day for adults and 2.5–5 mg per day for children aged six years and older. Depending on the individual's response to medication, the dose can be increased by 5 or 10 mg at weekly intervals until an optimal response is achieved. The maximum daily dosage is generally around 40 mg for adults and between 20-25 mg for children, divided into two doses that are spaced about four hours apart. If after several weeks there’s no significant improvement in symptoms at this maximal recommended dose, it may be necessary to reconsider the treatment strategy.
What are the most common side effects for Vyvanse?
Common side effects associated with the use of Vyvanse and Dexedrine include:
- Anxiety or restlessness
- Dry mouth
- Decreased appetite, leading to weight loss
- Insomnia (difficulty sleeping)
- Diarrhea, nausea or vomiting
- Increased heart rate, palpitations
- Dizziness, unsteadiness or shaking (tremors)
- Sweating excessively
- Headache These medications may also cause a decrease in libido and erectile dysfunction. Some people might experience mood changes such as agitation, nervousness or even symptoms resembling those of flu. It's important to note that these are stimulant medications used for attention deficit hyperactivity disorder (ADHD) and their side-effects can be quite similar due to their mechanism of action. However each individual might react differently so it is always advisable to consult your healthcare provider when starting new medication.
Are there any potential serious side effects for Vyvanse?
While both Vyvanse and Dexedrine are stimulant medications used to treat ADHD, they may have different side effects. For instance:
- Increased heart rate or palpitations can be experienced with both drugs, which could lead to chest pain, shortness of breath, or feelings of faintness.
- Signs of an allergic reaction: hives; difficulty breathing; swelling in your face or throat; fever and skin rash - these require immediate medical attention.
- Vision changes such as blurred sight or other vision disturbances could occur.
- Neurological symptoms might include headache, vertigo, confusion, agitation and tremors. In severe cases this can progress to hallucinations and paranoia.
- Low sodium levels - indicated by nausea, headache, confusion and fatigue. -Severe nervous system reactions like muscle stiffness (rigidity), high fever sweating fast/irregular heartbeat -Symptoms that mimic serotonin syndrome such as restlessness (agitation), hallucinations rapid heart rate muscle twitching/stiffness loss of coordination.
If any adverse effects persist or worsen while taking either medication it is crucial to seek immediate medical help.
What are the most common side effects for Dexedrine?
Common side effects associated with Dexedrine include:
- Dry mouth, unpleasant taste in the mouth
- Constipation or diarrhea
- Weight loss and decreased appetite
- Sleep problems (insomnia)
- Restlessness, tremors
- Headache, dizziness
- Increased heart rate or blood pressure
- Mood changes such as agitation, nervousness or paranoia
- Sweating excessively.
Remember that while these effects are common they may not occur in all patients and it's important to talk to your healthcare provider about any concerns.
Are there any potential serious side effects for Dexedrine?
While Dexedrine is an effective medication for conditions like ADHD and narcolepsy, it can cause potentially serious side effects in some people. The symptoms to watch out for include:
- Signs of an allergic reaction: hives, itching, fever, swollen glands, difficulty breathing or swelling in your face or throat
- Mood swings or behavior changes
- Hallucinations or new behavioral problems
- Chest pain coupled with trouble breathing
- Unexplained wounds on fingers and toes
- A sensation of numbness, cold feeling in the hands or feet (especially when accompanied by skin color changes)
- Muscle twitches (tics)
- Changes in vision such as blurred vision; seeing halos around lights If you experience any of these symptoms while taking Dexedrine, consult your doctor immediately.
Contraindications for Vyvanse and Dexedrine?
Both Vyvanse and Dexedrine, along with most other stimulant medications, may worsen symptoms of anxiety or agitation in some people. If you notice your anxiety worsening, an increase in restlessness or a significant change in behavior, please seek immediate medical attention.
Neither Vyvanse nor Dexedrine should be taken if you are taking, or have recently stopped taking monoamine oxidase (MAO) inhibitors. Always inform your physician about all the medications that you are currently on; MAO inhibitors will require a period of about 2 weeks to clear from the system to prevent dangerous interactions with Vyvanse and Dexedrine. These drugs can also interact negatively with certain antidepressants and blood pressure medicines among others so it's crucial to keep your healthcare provider informed.
How much do Vyvanse and Dexedrine cost?
For the brand name versions of these drugs:
- The price for 30 capsules of Vyvanse (50 mg) averages around $380, which works out to about $12.70/day.
- The price for 60 tablets of Dexedrine (10 mg) is approximately $420, thus costing you roughly $14/day.
Therefore, if you are in a higher dosage range for Dexedrine (i.e., 20mg or higher), then the brand-name Vyvanse would be less expensive on a per-day treatment basis. However, cost should not be your primary consideration when deciding between these two medications.
For generic versions of Vyvanse (Lisdexamfetamine Dimesylate) and Dexedrine (Dextroamphetamine):
- Generic Lisdexamfetamine Dimesylate isn't widely available; however, if found it's still relatively expensive with prices averaging from about $11 to $13 per day.
- Dextroamphetamine is more affordable and comes in packs starting from 15 up to several hundreds with costs ranging approximately from as low as $0.25/day up to around$1/day depending on the amount purchased upfront.
Popularity of Vyvanse and Dexedrine
Lisdexamfetamine, in generic form as well as brand names such as Vyvanse, was estimated to have been prescribed to about 10.7 million people in the US in 2019. Lisdexamfetamine accounted for just over 14% of ADHD prescriptions in the US. However, it appears to be the most-common “prodrug” stimulant (a substance that is metabolized into a pharmacologically active drug). The use of lisdexamfetamine has been generally increasing since its introduction in 2007.
Dextroamphetamine, including brand versions such as Dexedrine, was prescribed to approximately 400 thousand individuals in the USA during 2018-2019 period according to data from IQVIA Total Patient Tracker Database. In contrast with Vyvanse's growing prevalence, prescription rates for Dexedrine and other forms of dextroamphetamine have remained relatively stable over recent years due largely to an increased emphasis on newer extended-release formulations and prodrugs like lisdexamfetamine which are thought by many physicians to offer improved safety profiles and less potential for abuse.
Conclusion
Both Vyvanse (lisdexamfetamine) and Dexedrine (dextroamphetamine) have long-standing records of usage in patients with ADHD, backed by numerous clinical studies and meta-analyses indicating that they are more effective than placebo treatments. These medications can sometimes be combined under careful medical supervision, yet it's also important to note that they may interact adversely with other drugs. The primary difference between the two stems from their mechanisms of action: Vyvanse is a prodrug, which means it becomes active only after metabolic conversion in the body, while Dexedrine is an immediate-release medication.
Vyvanse has a longer duration of action compared to Dexedrine due to its unique pharmacokinetic profile. This makes Vyvanse suitable for once-daily dosing where as Dexedrine usually needs multiple doses throughout the day.
Both drugs are available in generic form but cost savings can vary depending on insurance coverage and individual pharmacies. Both Vyvanse and Dexedrine may require an adjustment period meaning that effects might not be noticeable right away.
The side effect profiles for both medications are similar, generally well-tolerated with common side effects like dry mouth, insomnia, loss of appetite or weight loss; however some people find lisdexamfetamine causes less abrupt withdrawal symptoms when it wears off compared to dextroamphetamine. For both medications patient must monitor their heart rate especially when starting treatment since these types of stimulants can increase heart rate or blood pressure.
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Refrences
- Cowles, B. J. (2009, March 31). Lisdexamfetamine for Treatment of Attention-Deficit/Hyperactivity Disorder. Annals of Pharmacotherapy. SAGE Publications.http://doi.org/10.1345/aph.1l521
- Dolder, P. C., Strajhar, P., Vizeli, P., Hammann, F., Odermatt, A., & Liechti, M. E. (2017, September 7). Pharmacokinetics and Pharmacodynamics of Lisdexamfetamine Compared with D-Amphetamine in Healthy Subjects. Frontiers in Pharmacology. Frontiers Media SA.http://doi.org/10.3389/fphar.2017.00617
- Heo, Y.-A., & Duggan, S. T. (2017, November). Lisdexamfetamine: A Review in Binge Eating Disorder. CNS Drugs. Springer Science and Business Media LLC.http://doi.org/10.1007/s40263-017-0477-1
- Howland, R. H. (2008, August). Lisdexamfetamine: A Prodrug Stimulant for ADHD. Journal of Psychosocial Nursing and Mental Health Services. SLACK, Inc.http://doi.org/10.3928/02793695-20080801-05
- Madaan, V., & Domnitei. (2010, May). New and extended-action treatments in the management of ADHD: a critical appraisal of lisdexamfetamine in adults and children. Neuropsychiatric Disease and Treatment. Informa UK Limited.http://doi.org/10.2147/ndt.s3328