From the Guidelines
If you're not tolerating Vyvanse and Concerta, your next best option for ADHD treatment would likely be lisdexamfetamine, as it is preferred over non-stimulants after inadequate response to methylphenidate 1.
Key Considerations
When considering alternative treatments, it's crucial to evaluate the specific side effects experienced with Vyvanse and Concerta, as well as individual patient factors such as symptom severity, presence of comorbidities, and personal preferences 1.
- Lisdexamfetamine is a stimulant with a different formulation that some people may tolerate better than Vyvanse or Concerta.
- Non-stimulant options like atomoxetine (Strattera) or alpha-2 adrenergic agonists (e.g., clonidine, guanfacine) may also be considered, especially if there are concerns about stimulant use or if the patient has certain comorbidities 1.
Medication Adherence
Regular assessment of medication adherence and open discussion of potential issues are vital to ensure effective treatment and minimize adverse events 1.
- Factors influencing adherence, such as patient attitudes, physician-patient relationship, family support, and knowledge about the disorder and medication, should be evaluated and addressed before initiating pharmacological treatment 1.
Dosing Regimen
Once-daily dosing is generally preferred over twice-daily dosing to improve medication adherence 1.
- The dosing regimen for lisdexamfetamine or other alternative medications should be individualized based on patient response and tolerability. It's essential to consult with a healthcare provider before making any medication changes, as they can provide personalized guidance and recommendations based on the patient's unique situation 1.
From the Research
Alternative Treatment Options
If you are not tolerating Vyvanse and Concerta, there are other treatment options available for Attention-Deficit Hyperactivity Disorder (ADHD).
- Lisdexamfetamine is a prodrug that has shown efficacy in treating ADHD in children and adolescents, with a faster and more robust treatment response compared to atomoxetine 2.
- Mixed amphetamine salts and methylphenidate are also effective treatments for ADHD, although they may have a lower effect size compared to lisdexamfetamine 3, 4, 5.
- Modafinil has not shown significant efficacy in treating ADHD in adults 3.
- Bupropion has shown small efficacy in reducing ADHD symptoms in children and adolescents, but more research is needed to fully evaluate its effectiveness 5.
Efficacy and Safety
The efficacy and safety of these alternative treatments have been evaluated in various studies.
- Lisdexamfetamine has been shown to have a high effect size in reducing ADHD symptoms, with a promising potential for treating adults with ADHD 3.
- The safety profiles of lisdexamfetamine and atomoxetine have been found to be consistent with previous clinical trials, with common adverse events including increased heart rate and blood pressure, and decreased weight 2.
- Methylphenidate has been found to have a modest effect size in reducing ADHD symptoms, with a lower risk of treatment discontinuation compared to placebo 5.
Considerations
When considering alternative treatment options, it is essential to consult with a healthcare professional to determine the best course of treatment for your specific needs.
- Factors such as age, medical history, and comorbid conditions should be taken into account when selecting a treatment option 4, 5.
- The potential for abuse and dependence should also be considered, as lisdexamfetamine has been found to have a reduced potential for abuse compared to other stimulants 6.