What are the effects of overstimulation with Vyvanse (Lisdexamfetamine)?

From the Guidelines

If you're experiencing overstimulation with Vyvanse, you should contact your healthcare provider to discuss adjusting your dosage or medication regimen immediately, as this can help mitigate potential adverse effects on morbidity, mortality, and quality of life. Vyvanse (lisdexamfetamine) is a stimulant medication used for ADHD and binge eating disorder that can sometimes cause overstimulation symptoms like anxiety, restlessness, racing thoughts, increased heart rate, elevated blood pressure, insomnia, or feeling jittery 1. Your doctor might recommend reducing your dose (typically available in strengths from 10mg to 70mg), taking it earlier in the day to prevent sleep issues, or switching to a different medication like Concerta, Adderall, or a non-stimulant option 1.

While waiting to see your doctor, it is essential to:

• Stay hydrated
• Avoid caffeine and other stimulants
• Eat regular meals
• Practice relaxation techniques
• Maintain a consistent sleep schedule

Overstimulation occurs because Vyvanse increases dopamine and norepinephrine levels in the brain, which at excessive levels can lead to these uncomfortable symptoms 1. Everyone has different sensitivity to stimulants, so finding the right dose that manages your condition without causing overstimulation is essential. The Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) study results identified stimulants as having a more persistent effect on decreasing growth velocity compared to most previous studies, particularly when children were on higher and more consistently administered doses 1.

It is crucial to note that stimulant medications can have adverse effects, including appetite loss, abdominal pain, headaches, and sleep disturbance, and in rare cases, hallucinations and other psychotic symptoms 1. Although concerns have been raised about sudden cardiac death among children using stimulant medications, evidence suggests that sudden death in children on stimulant medication is extremely rare 1. Nevertheless, before initiating therapy with stimulant medications, it is essential to obtain the child or adolescent’s history of specific cardiac symptoms, in addition to the family history of sudden death, cardiovascular symptoms, Wolff-Parkinson-White syndrome, hypertrophic cardiomyopathy, and long QT syndrome 1.

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.

Overstimulation with Vyvanse can occur due to its potential for abuse and misuse, leading to increased heart rate, blood pressure, and other symptoms.

• Symptoms of overstimulation may include hyperactivity, restlessness, insomnia, and decreased appetite.
• Severe cases can result in anxiety, psychosis, hostility, aggression, and suicidal or homicidal ideation. 2 2

From the Research

Overstimulation with Vyvanse

• Overstimulation is a potential side effect of Vyvanse (lisdexamfetamine), a medication commonly used to treat attention-deficit/hyperactivity disorder (ADHD) 3, 4, 5, 6, 7.
• Studies have shown that Vyvanse can cause adverse events such as decreased appetite, insomnia, irritability/aggression, weight decrease, and mood swings 3, 4, 5, 6, 7.
• The frequency and severity of these adverse events can vary depending on the individual and the dosage of Vyvanse 3, 4, 5, 6, 7.
• Some studies have compared the efficacy and safety of Vyvanse with other ADHD medications, such as methylphenidate and atomoxetine 3, 4, 5, 6, 7.
• These studies have found that Vyvanse can be an effective treatment option for ADHD, but it may have a higher risk of certain adverse events compared to other medications 3, 4, 5, 6, 7.

Comparison with Other Medications

• A study published in 2013 found that Vyvanse had a faster and more robust treatment response than atomoxetine in children and adolescents with ADHD 3.
• A meta-analysis published in 2019 found that Vyvanse had a high effect size in reducing ADHD symptoms in adults, compared to other medications such as methylphenidate and modafinil 4.
• A study published in 2024 found that centanafadine had a lower incidence of adverse events compared to Vyvanse, but Vyvanse had a more robust treatment response 5.
• Another study published in 2024 found that switching from methylphenidate to Vyvanse was a common practice in the treatment of ADHD in children, and that Vyvanse had a similar adverse event profile to methylphenidate 6.
• A systematic review published in 2014 found that Vyvanse had a higher probability of treatment response compared to other ADHD medications, including methylphenidate and atomoxetine 7.