Vyvanse FDA-Approved Indications
Vyvanse (lisdexamfetamine) is FDA-approved for two specific indications: (1) Attention Deficit Hyperactivity Disorder (ADHD) in adults and pediatric patients 6 years and older, and (2) moderate to severe binge eating disorder (BED) in adults. 1
Primary Indications
ADHD Treatment
- Approved for patients ≥6 years of age (both adults and children)
- Starting dose: 30 mg once daily in the morning
- Titration: Increase by 10-20 mg increments at weekly intervals
- Maximum dose: 70 mg once daily 1
Important limitation: Pediatric patients younger than 6 years experienced more long-term weight loss than older patients, making use in this age group not recommended despite dextroamphetamine (the active metabolite) having FDA approval for younger children 1
Binge Eating Disorder (BED)
- Approved only for adults with moderate to severe BED
- Starting dose: 30 mg once daily
- Titration: Increase by 20 mg increments at weekly intervals
- Target dose: 50-70 mg once daily
- Maximum dose: 70 mg once daily
- Discontinue if binge eating does not improve 1
The APA eating disorders guideline suggests lisdexamfetamine as an option for adults with binge-eating disorder who prefer medication or have not responded to psychotherapy alone 2
Critical Limitations and Warnings
Vyvanse is NOT indicated for weight loss. The FDA label explicitly states that use of sympathomimetic drugs for weight loss has been associated with serious cardiovascular adverse events, and the safety and effectiveness of Vyvanse for obesity treatment have not been established 1
Abuse Potential Considerations
Lisdexamfetamine has a unique prodrug mechanism—it requires enzymatic conversion by red blood cell peptidases to become active dextroamphetamine—which provides lower abuse potential compared to immediate-release amphetamines 3. The AAP ADHD guidelines specifically mention Vyvanse as having "less abuse potential" because it is only activated after ingestion and cannot be easily extracted for alternative routes of administration 3
This makes it a preferred option in adolescents at risk for medication diversion, though all patients still require assessment for abuse risk before prescribing and ongoing monitoring 1