From the Guidelines
Vyvanse and Adderall are both stimulant medications used to treat ADHD, but Vyvanse is generally considered to have a smoother effect with fewer ups and downs throughout the day compared to Adderall, and is less likely to be misused due to its prodrug mechanism of action. The key differences between Vyvanse and Adderall lie in their composition, onset of action, duration of effects, and potential for misuse. Vyvanse (lisdexamfetamine) is a prodrug that must be metabolized by the body into its active form, dextroamphetamine, resulting in a gradual onset of effects and typically lasting 10-14 hours 1. This metabolism process makes Vyvanse less likely to be misused since it cannot be altered for faster absorption. Adderall, on the other hand, contains a mixture of amphetamine salts (75% dextroamphetamine and 25% levoamphetamine) that work immediately upon ingestion, with immediate-release versions lasting 4-6 hours and extended-release (Adderall XR) lasting 8-12 hours 1.
Some of the main points to consider when choosing between Vyvanse and Adderall include:
- Onset and duration of action: Vyvanse has a gradual onset and longer duration of action compared to Adderall
- Potential for misuse: Vyvanse is considered to have a lower potential for misuse due to its prodrug mechanism of action
- Side effect profiles: Both medications have similar side effect profiles, including potential appetite suppression, sleep difficulties, and cardiovascular effects
- Dosing: Vyvanse is typically prescribed once daily, while Adderall may be taken multiple times daily or as an extended-release formulation
It's also important to consider the individual patient's needs and circumstances, such as the presence of comorbidities, potential for substance abuse, and personal preferences, when deciding between Vyvanse and Adderall 1. Ultimately, the choice between Vyvanse and Adderall should be based on a thorough evaluation of the patient's specific needs and circumstances, and should be made in consultation with a qualified healthcare professional 1.
From the FDA Drug Label
12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action Lisdexamfetamine is a prodrug of dextroamphetamine. Amphetamines are non-catecholamine sympathomimetic amines with CNS stimulant activity.
The main difference between Vyvanse (lisdexamfetamine) and Adderall is that Vyvanse is a prodrug of dextroamphetamine, whereas Adderall is a mixture of amphetamine salts.
- Mechanism of action: Both drugs have CNS stimulant activity, but the exact mode of therapeutic action is not known.
- Pharmacodynamics: Both block the reuptake of norepinephrine and dopamine into the presynaptic neuron and increase the release of these monoamines into the extraneuronal space.
- Key difference: Vyvanse is converted into dextroamphetamine in the body, whereas Adderall contains a mixture of amphetamine salts, including dextroamphetamine and amphetamine. 2
From the Research
Difference between Vyvanse and Adderall
- Vyvanse (lisdexamfetamine) and Adderall (mixed amphetamine salts) are both stimulant medications used to treat Attention Deficit Hyperactivity Disorder (ADHD) 3, 4.
- Vyvanse is a prodrug, which means it is inactive until it is metabolized into its active form, d-amphetamine, whereas Adderall is a mixture of amphetamine salts that are active immediately 3, 5.
- Studies have shown that both medications are effective in reducing ADHD symptoms, but Vyvanse may have a longer duration of action and be less likely to be abused 6, 5.
- In terms of side effects, both medications can increase blood pressure and heart rate, but Vyvanse may have a lower risk of adverse effects compared to Adderall 7, 5.
- A study comparing the two medications found that Vyvanse had significant and equal reductions in ADHD clinician ratings, and significantly greater reductions in Clinical Global Impression Severity Scale (CGI-S) and selected Behavior Rating Inventory of Executive Function (BRIEF) subsets compared to Adderall 5.
- Treatment adherence was also found to be better with Vyvanse compared to other ADHD medications, including Adderall, in a retrospective analysis 6.