Average Effective Dose of Vyvanse (Lisdexamfetamine) for ADHD Treatment
The average effective dose of Vyvanse (lisdexamfetamine) for ADHD treatment ranges from 30-70 mg once daily, with most patients responding optimally to doses of 50-70 mg daily.
Dosing Guidelines
Initial Dosing and Titration
- Starting dose: 30 mg once daily in the morning 1
- Titration schedule:
Dose Optimization
- Dose optimization typically takes 4 weeks, followed by dose maintenance 2
- The American Academy of Pediatrics recommends regular monitoring every 3-4 weeks during dose titration 1
- Once stabilized, follow-up should occur every 3-6 months 1
Efficacy by Dose
Clinical studies have demonstrated efficacy across all approved doses:
- 30 mg/day: Shows significant improvement over placebo but may be less effective than higher doses for many patients 2
- 50 mg/day: Provides robust symptom control for most patients 2
- 70 mg/day: Maximum approved dose, often needed for optimal symptom control in patients with more severe ADHD 2
Studies show that all doses (30,50, and 70 mg) demonstrate statistically significant improvements compared to placebo on the ADHD Rating Scale (ADHD-RS-IV) 2, 3. However, the higher doses (50-70 mg) typically provide greater symptom reduction.
Response Time
Lisdexamfetamine demonstrates a relatively rapid onset of action:
- Median time to first clinical response: 12 days 4
- By week 9 of treatment, approximately 81.7% of patients show a clinical response 4
- Duration of action: Approximately 14 hours post-dose in adults, providing all-day symptom control 5
Special Considerations
Monitoring Parameters
- Regular monitoring of vital signs, weight, appetite, sleep patterns, and mood changes is essential 1
- Growth parameters should be monitored in pediatric patients 1
Common Side Effects (>10% incidence)
- Decreased appetite
- Insomnia
- Headache 6
Cardiovascular Effects
- Small increases in blood pressure (average +0.7 mmHg systolic) and pulse rate (average +3.6 bpm) may occur 4
- Weight decrease (average -1.3 kg) is commonly observed 4
Clinical Pearl
Lisdexamfetamine is a prodrug that is converted to active d-amphetamine primarily by red blood cells, which provides a more gradual onset and longer duration of action compared to immediate-release stimulants 5, 6. This unique pharmacokinetic profile allows for once-daily dosing with approximately 12 hours of symptom control, making it particularly useful for patients requiring extended coverage throughout the day.
While the FDA-approved dose range is 30-70 mg daily, clinical practice and research suggest that many patients achieve optimal symptom control at doses of 50-70 mg daily, with some patients responding adequately to the 30 mg dose.