Comparing Vyvanse vs. Adderall (2024)

Vyvanse (lisdexamfetamine) and Adderall (amphetamine/dextroamphetamine) are two drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment of attention-deficit/hyperactivity disorder (ADHD).

Although both drugs are classified as central nervous system (CNS) stimulants, there are differences in how they are metabolized by the body and how effective they are in treating ADHD. This includes the immediate-release version of Adderall called Adderall IR and the extended-release version called Adderall XR.

Vynanse can also be used to treat binge eating disorder (BED), while Adderall may be prescribed to treat narcolepsy (a type of sleeping disorder).

This article explains the differences between Vyvanse and Adderall, including how they are used and which are more effective (and why). It also describes the recommended dosages, side effects, interactions, and when the drugs should not be used.

Vyvanse vs. Adderall: Main Differences

Vyvanse, Adderall IR, and Adderall XR are CNS stimulants that work by increasing levels of dopamineandnorepinephrine in the brain. Dopamine and norepinephrine are chemical messengers called neurotransmitters that work by carrying messages from one nerve cell to the next.

In people with ADHD, increased levels of dopamine and norepinephrine can help improve alertness, increase focus, and sustain thought, effort, and motivation.

This doesn't mean that Vyvanse, Adderall IR, and Adderall XR are the same or can be used interchangeably.

Metabolism and Absorption in the Body

Vyvanse and Adderall differ in their active ingredients, but more importantly is how those ingredients are absorbed and metabolized by the body.

Drug metabolization is the process wherein drugs are transformed by the body so that they can be eliminated more easily. This mostly occurs in the liver.

Where Vyvanse differs is that it is a prodrug, whereas Adderall is an active drug.

With an active drug like Adderall, the ingredients amphetamine and dextroamphetamine directly increase levels of dopamine and norepinephrine in the brain. When the drugs are metabolized, they become inactive and are eliminated.

With a prodrug like Vyvanse, the ingredient lisdexamfetamine is inactive. It is only when it is metabolized by the liver that the active drug (dextroamphetamine) is released into the bloodstream. Once dopamine and norepinephrine levels are increased, dextroamphetamine is inactivated and eliminated.

The benefit of a prodrug like Vyvanse is that it takes less medication to achieve the same effect as an active drug like Adderall. Because of this, prodrugs are less likely to cause toxicity or side effects.

Moreover, a higher proportion of the active drug enters the bloodstream with a prodrug like Vyvanse than an active drug like Adderall. This is because only a portion of Adderall you take by mouth is absorbed into the bloodstream.

Indications for Treatment

Vyvanse, Adderall IR, and Adderall XR can all treat ADHD but vary in how they are used and in whom they can be used.

Vyvanse is approved to treat:

• ADHD in adults and children 6 years and older
• Moderate to severe BED in adults 18 and older

Adderall IR is approved to treat:

• ADHD in adults and children 3 years and older
• Narcolepsy in adults and children 6 and older

Adderall XR is FDA-approved to treat:

• ADHD in adults and children 6 year and older
  

How to Take Each Medication

Vyvanse, Adderall IR, and Adderall XR are oral drugs that are taken by mouth in one or several doses with or without food. The drugs are prescribed at a lower dose and gradually increased, if needed, to achieve the desired effect.

All three drugs are available as generics.

Vyvanse

Vyvanse, available as an oral capsule and chewable tablet, is prescribed in milligrams (mg) in the following dosages:

• ADHD (adults and children 6 and older): 30 to 70 mg once daily in the morning (maximum dose 70 mg per day)
• BED (adults): 50 to 70 mg once daily in the morning (maximum dose 70 mg per day)

Adderall IR

Adderall IR, available as an oral tablet, is prescribed in the following dosages:

• ADHD (adult and children 6 and older): 5 to 40 mg daily divided into one, two, or three doses (maximum dose 40 mg per day)
• ADHD (children 3 to 5 years): 2.5 mg to 40 mg daily divided into one, two, or three doses (maximum dose 40 mg per day)
• Narcolepsy: 5 mg to 60 mg daily, divided into one, two, or three doses (maximum dose 60 mg per day)

Adderall XR

Adderall XR, available as an oral capsule, is only used to treat ADHD. It is prescribed as follows:

• ADHD (adults): 20 mg once daily in the morning (maximum dose 60 mg per day)
• ADHD (children 6 to 12 years): 10 mg once daily in the morning (maximum 30 mg per day)
• ADHD (children 13 to 17 years): 10 mg to 20 mg once daily in the morning (maximum 40 mg per day)
  

Side Effects

Vyvanse and Adderall have strikingly similar side effects. With that being said, Vyvanse is less likely to have intolerable side effects that may cause a person to skip a dose or discontinue treatment.

Serious Side Effects

Serious side effects, while uncommon, can occur with both Vyvanse and Adderall. These include:

• Seizures (sudden, uncontrollable body jerks)
• Psychosis (disconnection from reality)
• Mania (extremely elevated, excited mood)
• Priapism (a prolonged and painful erection)
  
• Stevens-Johnson syndrome (a potentially deadly drug reaction causing peeling, blistering skin)
• Anaphylaxis (a potentially life-threatening, whole-body allergic reaction)

Seek immediate medical care if you have signs or symptoms of any of these condtions.

Additionally, children may experience short-term growth delays while taking Vyvanse or Adderall, so close monitoring by a pediatrician is needed.

Who Should Avoid Vyvanse or Adderall?

CNS stimulants are contraindicated for use in certain people. Absolute contraindications for Vyvanse and Adderall include:

• Taking a monoamine oxidase inhibitor (MAOI) within the past 14 days
• Being pregnant or breastfeeding
• Having severe heart disease

Adderall or Vyvanse may be prescribed with caution if the healthcare provider determines that doing so is safe for people with:

• Chronic kidney disease
• Heart disease
• Hypertension (high blood pressure)
• Hyperthyroidism (overactive thyroid)
• Glaucoma
• Mental health conditions, such as bipolar disorder
• A history of seizures
• A history of substance abuse
  

Drug Interactions

CNS stimulants like Vyvanse and Adderall can cause drug interactions, some of which may be serious. Advise your healthcare provider if you take any of the following before starting treatment:

• Antidepressants, including MAOIs and tricyclic antidepressants
• Blood pressure medications
• Anticonvulsant drugs like Dilantin (phenytoin)
• Anticoagulants (blood thinners) like warfarin
• Decongestants like Claritin-D (loratadine)
• Opioid pain relievers
• Donnatal (belladonna/phenobarbital)
• Adipex-P (phentermine)
  
• Lithium
  

Which Drug Is More Effective for ADHD?

When comparing ADHD medications, Vyvanse and Adderall XR are clearly advantageous because you only need to take one dose per day. This makes drug adherence easier, which most studies suggest improves the effectiveness of treatment.

By way of comparison:

• Vyvanse capsules take about around three hours to reach the full effect, while chewable tablets take about four hours to reach the full effect. A dose of Vyvanse lasts for up to 14 hours.
• Adderall XR capsules take about seven hours to reach the full effect, and a dose lasts up to 12 hours.

By contrast, Adderall IR has a shorter drug half-life (meaning the speed at which a drug is eliminated from the body), meaning that you have to take it more often to keep drug concentrations at adequate levels in the bloodstream.

A review of studies published in 2019 compared Vyvanse against several other ADHD drugs, including Adderall, and concluded that Vyvanse was more effective overall.

According to the researchers, Vyvanse had less profound side effects and was more easily tolerated than other CNS stimulants. Because of this, users were more likely to adhere to daily treatment and, in turn, have better clinical outcomes.

Summary

Vyvanse and Adderall are prescription stimulant medications used to treat ADHD in adults and children. Although Vyvanse and Adderall have similar side effects, drug interactions, and contraindications, they have specific indications for use, different dosages, and different levels of efficacy.