From the Guidelines
Lisdexamfetamine can produce noticeable symptoms in someone under its influence, including increased heart rate, elevated blood pressure, reduced appetite, and behavioral changes such as increased alertness and focus, as reported in a study published in Pediatrics in 2019 1. These symptoms occur because lisdexamfetamine is converted in the body to dextroamphetamine, which increases levels of neurotransmitters like dopamine and norepinephrine in the brain, stimulating the central nervous system. Some key points to consider when evaluating someone under the influence of lisdexamfetamine include:
- Physical symptoms: increased heart rate, elevated blood pressure, reduced appetite, dry mouth, headache, and insomnia
- Behavioral changes: increased alertness, enhanced focus and concentration, elevated energy levels, and potentially heightened talkativeness or sociability
- Potential adverse effects: anxiety, restlessness, irritability, and potentially agitation, especially at higher doses or with recreational use
- Importance of monitoring vital signs, such as heart rate and blood pressure, as stimulant medications can increase these parameters to a mild and clinically insignificant degree, but may be more substantial in a subset of individuals 1 The effects of lisdexamfetamine typically begin 1-2 hours after ingestion and can last 10-14 hours due to the medication's extended-release design. It is essential to be aware of the potential for more severe symptoms, such as those associated with serotonin syndrome, which can include agitation, delirium, and autonomic instability, as described in a study published in Pediatrics in 2016 1. In cases where lisdexamfetamine is suspected to be the cause of severe symptoms, treatment may involve discontinuing the medication, providing supportive care, and potentially using specific therapies such as benzodiazepines for agitation or serotonin2A antagonists for serotonin syndrome.
From the FDA Drug Label
Misuse and abuse of lisdexamfetamine, a prodrug of amphetamine, may cause increased heart rate, respiratory rate, or blood pressure; sweating; dilated pupils; hyperactivity; restlessness; insomnia; decreased appetite; loss of coordination; tremors; flushed skin; vomiting; and/or abdominal pain Anxiety, psychosis, hostility, aggression, and suicidal or homicidal ideation have also been observed with CNS stimulants abuse and/or misuse.
The symptoms of someone under the influence of Lisdexamphetamine may include:
- Increased heart rate
- Increased respiratory rate
- Increased blood pressure
- Sweating
- Dilated pupils
- Hyperactivity
- Restlessness
- Insomnia
- Decreased appetite
- Loss of coordination
- Tremors
- Flushed skin
- Vomiting
- Abdominal pain
- Anxiety
- Psychosis
- Hostility
- Aggression
- Suicidal or homicidal ideation 2 2
From the Research
Symptoms of Lisdexamfetamine Influence
- The provided studies do not directly address the symptoms of someone under the influence of Lisdexamfetamine 3, 4, 5, 6, 7.
- However, it can be inferred that the effects of Lisdexamfetamine are similar to those of d-amphetamine, as Lisdexamfetamine is a prodrug that is converted to d-amphetamine in the body 3, 5, 7.
- The studies suggest that Lisdexamfetamine has a longer time to reach maximum concentration (Tmax) and a lower maximum concentration (Cmax) compared to d-amphetamine, which may result in a diminished feeling of euphoria 6.
- Common adverse events associated with Lisdexamfetamine include insomnia, loss of energy, and weight gain or loss 4.
- The pharmacokinetic properties of Lisdexamfetamine, such as its slow release and long duration of action, may contribute to its therapeutic effects and potential for abuse 5, 6, 7.
Abuse Potential
- The potential for abuse of Lisdexamfetamine is considered to be lower than that of immediate-release d-amphetamine due to its prodrug property and slower release 6.
- However, some studies suggest that Lisdexamfetamine may still have reinforcing properties and a potential for abuse, particularly at high doses 6.
- Epidemiological studies have found that abuse rates of Lisdexamfetamine are substantially lower than those of immediate-release d-amphetamine 6.