Can you experience withdrawal symptoms in the evening after taking Vyvanse (lisdexamfetamine) 40mg in the morning?

Evening Withdrawal from Morning Vyvanse 40mg

Yes, you can experience withdrawal symptoms in the evening after taking Vyvanse 40mg in the morning, as the medication's effects wear off approximately 10-14 hours after dosing, and withdrawal symptoms can begin within hours of declining drug levels in physically dependent individuals. 1

Understanding Vyvanse Pharmacology and Withdrawal Risk

• Lisdexamfetamine (Vyvanse) is a prodrug that converts to d-amphetamine through enzymatic processes in red blood cells, providing extended stimulant effects throughout the day 2
• The medication demonstrates efficacy up to 14 hours post-dose in adults, meaning effects typically begin declining in the late afternoon or evening after morning administration 2
• All patients treated with long-term amphetamine therapy develop physical dependence, making withdrawal symptoms possible when drug levels decline 3, 1

Typical Evening Withdrawal Symptoms

Physical withdrawal symptoms from amphetamines that may occur in the evening include:

• Dysphoric mood and depression 1
• Fatigue and lethargy (often the most prominent evening symptom) 1
• Increased appetite 1
• Irritability and anxiety 3
• Difficulty concentrating 3
• Psychomotor agitation or retardation 1

Distinguishing Withdrawal from Symptom Return

A critical clinical distinction must be made:

• True withdrawal symptoms represent new or amplified symptoms beyond your baseline ADHD presentation 3
• Symptom return is simply the re-emergence of your underlying ADHD symptoms as medication wears off 3
• Pain or discomfort may be a withdrawal symptom itself, not just exacerbation of pre-existing conditions, as descending pain facilitatory tracts show increased firing during early abstinence 3

Risk Factors for Evening Withdrawal

You are at higher risk for experiencing evening withdrawal if:

• You have been taking Vyvanse continuously for 5 or more days, as tolerance and physical dependence develop rapidly with stimulants 3
• You are taking higher doses (though 40mg is a moderate dose) 1
• You have concurrent use of other substances or medications 3

Management Strategies

If you are experiencing problematic evening symptoms:

• Do not abruptly discontinue or skip doses, as this can precipitate acute withdrawal 1
• Consider discussing with your prescriber whether afternoon dosing adjustments are appropriate, though the FDA label recommends avoiding afternoon doses due to insomnia risk 1
• Adjuvant medications can be used liberally to manage specific withdrawal symptoms: clonidine for anxiety and autonomic symptoms, antiemetics for nausea 3, 4
• Non-stimulant medications or behavioral interventions may help bridge the evening period 3

Important Caveats

• The FDA warns of serious withdrawal symptoms when CNS stimulants are abruptly discontinued, emphasizing the importance of gradual tapering if discontinuation is planned 3, 1
• Evening symptoms lasting beyond 24-48 hours after your last dose suggest either protracted withdrawal or return of underlying symptoms requiring clinical evaluation 3, 1
• Anxiety and depressive symptoms may emerge or intensify during withdrawal periods, which can be difficult to distinguish from baseline psychiatric conditions 3