There are currently several options to treat attention-deficit/hyperactivity disorder (ADHD), a neurodevelopmental issue that can cause inattention, hyperactivity, and impulsive behavior in adults and children.
Stimulant medications are a commonly prescribed pharmaceutical option. These medications increase levels of certain neurotransmitters (brain chemicals) to improve concentration and focus and to help reduce hyperactive and impulsive behavior.
Lisdexamfetamine (Vyvanse) and mixed salts amphetamine (Adderall) are two stimulants commonly prescribed to treat ADHD. Both drugs can be effective, but the differences in some of their features may make one of them a better choice for you.
Vyvanse and Adderall are both amphetamines (a type of stimulant), so they work in much the same way — stimulating the nervous system and increasing the amount of neurotransmitters such as dopamine and norepinephrine in the brain.
Adderall has been around longer than Vyvanse. The
One of the main differences between Vyvanse and immediate-release Adderall is that Vyvanse is less likely to be misused than Adderall. This is because it’s manufactured to have a slower chemical release, allowing for once-daily dosing.
Both Adderall and Vyvanse have been FDA approved to treat health issues other than ADHD:
- Vyvanse: approved for treating binge eating disorder
- Adderall: approved to help treat a sleep disorder called narcolepsy
While these two drugs act similarly inside the body, they have different active ingredients.
- Dextroamphetamine and amphetamine are the active ingredients in Adderall.
- Lisdexamfetamine is the active ingredient in Vyvanse.
Vyvanse and Adderall are both approved to treat ADHD in people ages 6 years and older. In fact, they’re both included in the group of drugs used as first-line treatments for ADHD in children to help them focus their attention in the classroom and when studying.
Generally, it’s difficult to tell whether one of these drugs works better than the other across the board because very few head-to-head studies have compared Adderall and Vyvanse.
It may come down to the fact that everyone reacts differently to medication. Vyvanse may work well for one person, while another may respond better to Adderall. The good news is that both drugs have been studied extensively on their own and showed positive results.
The effectiveness of Vyvanse has been shown in longer and short-term studies, involving both children and adults.
Adderall has also been deemed effective in short-term and longer-term studies, as evidenced from this
Because Adderall and Vyvanse are both stimulants, they share similar side effects. A few common side effects include:
Less common side effects of both drugs include:
- hallucinations, which means seeing or hearing something that is not there
- increased heart rate
- high blood pressure
- mania, which refers to a period of intense energy
- paranoia, which is feeling as though someone is out to get you
- shortness of breath
In rare cases, both of these drugs can increase the risk of heart problems such as high blood pressure and increased heart rate, heart attack, stroke, and even death. Before starting Vyvanse or Adderall, get a heart checkup and tell your doctor about any history of high blood pressure or heart problems.
Because Adderall is more easily misused because it works quickly when crushed up and used, it may have a higher potential for misuse in individuals with a history of addiction.
Due to the way it requires enzymes in the body to convert it into its active form, Vyvanse is less likely to be misused — but it’s still classified as a schedule II controlled substance.
The brand-name versions of both drugs are similar in cost.
Adderall is also available as a generic drug, but Vyvanse is not. Generic drugs are often much less expensive than brand-name drugs.
Many factors — such as insurance coverage, pharmacy, location, and discounts — can affect prescription drug prices.
Your doctor will recommend a medication based on how well it works for your specific situation. This is a good time to talk to them and your pharmacist about medication costs.
Asking your doctor about changing to another drug to save costs may require dosage changes and adjustments, which can also affect costs in the end.
Considering your other medications may help you decide which ADHD drug is right for you. Adderall and Vyvanse can both interact with certain other medications or chemicals. A few examples include:
- Acidifying agents. These include ascorbic acid and fruit juices. These acidic ingredients might lower the amount of drug that the body absorbs.
- Alkalinizing agents. These include sodium bicarbonate, the main ingredient in baking soda. Alkalizing agents are the opposite of acids. They might increase the body’s absorption of these drugs.
- Monoamine oxidase inhibitors (MOIs). Individuals taking stimulants like Adderall and Vyvanse along with MOIs, which are a separate class of antidepressants, should be closely monitored. This drug combination (a stimulant and an MOI) may produce severe health complications in certain people.
- Opioids. Mixing a stimulant (like Adderall or Vyvanse) and an opioid (like Vicodin or OxyContin) can create physiological and mental complications, including addiction. Individuals who have been prescribed both types of drugs should be closely monitored by their doctor.
Like other stimulants, Adderall may cause peripheral vasculopathy, including Raynaud’s phenomenon. Peripheral vasculopathy can cause vascular issues with symptoms that include fatigue and leg cramping.
Proton pump inhibitors can also have a negative effect on Adderall and increase the amount the body absorbs.
Talk with your doctor about other interactions with Adderall specifically, including those that can commonly occur.
Occasionally, Vyvanse can create an adverse reaction with CYP2D6 inhibitors like Wellbutrin and Cymbalta. These CYP2D6 inhibitors can increase the body’s absorption of Vyvanse.
Because many of its possible adverse reactions overlap with Adderall, it’s best to talk with your doctor about pros and cons specific to your situation when taking Vyvanse.
Vyvanse and Adderall have both been shown to be effective for treating ADHD. The biggest differences between the two drugs are:
- the forms
- how often you take them
- their potential for misuse
Work with your healthcare professional to choose the medication that works best for you or your child.
Picking the right ADHD drug is sometimes a matter of trial and error. If the first drug you choose doesn’t work or presents with too many negative side effects, you can talk with your healthcare professional about trying a different medication.