From the Research
Switching to Vyvanse (lisdexamfetamine) is unlikely to worsen seizures in patients with epilepsy and ADHD, as recent evidence suggests that ADHD medications do not increase the risk of seizures, even in patients with epilepsy. According to a 2021 study published in Current Opinion in Neurology 1, treatment with methylphenidate is associated with clinically significant improvement of ADHD symptoms in 60-75% of patients, and recent data reinforce the hypothesis that ADHD medications do not increase the risk of seizures, even in patients with epilepsy. Another study published in Epilepsia in 2019 found that ADHD medication periods were associated with a reduced rate of acute seizures (hazard ratio 0.73,95% confidence interval 0.57-0.94) compared to non-medication periods within the same individual 2.
When considering switching to Vyvanse, it is essential to:
- Initiate the medication cautiously, typically starting at a low dose (such as 20 or 30 mg daily) and gradually increasing while monitoring for seizure activity
- Collaborate closely between a neurologist and psychiatrist during this transition
- Monitor patients for potential seizure triggers, especially during the first month of treatment, as suggested by a 2020 study published in The Lancet Child & Adolescent Health 3
- Consider non-stimulant ADHD medications like atomoxetine (Strattera) or guanfacine (Intuniv) as safer alternatives for patients with poorly controlled epilepsy
Overall, the current evidence suggests that Vyvanse can be a safe and effective treatment option for patients with ADHD and epilepsy, as long as it is initiated and monitored carefully. Any increase in seizure activity after starting Vyvanse should prompt immediate medical attention and possible medication adjustment.