Adderall and Vyvanse are prescription psychostimulant drugs used to treat attention deficit hyperactivity disorder (ADHD). While Adderall is sometimes the more effective of the two, Vyvanse is considered less addictive. Adderall is a combination of dextroamphetamine and amphetamine; in Vyvanse, the active ingredient is lisdexamfetamine.

Comparison chart

Adderall versus Vyvanse comparison chart
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Type of drug Psychostimulant Psychostimulant
Used to treat ADHD, narcolepsy ADHD
Active Ingredient mixed amphetamine salts - Dextroamphetamine and Levoamphetamine. 25% is the inactive L-enantiomer. Lisdexamfetamine
Forms Available Tablet (5, 7.5, 10, 12.5, 20, 30 mg) or extended-release capsule (5, 10, 15, 20, 25, 30, 36 mg) Capsules
Legal status ℞ Prescription only; Schedule II (US) and Schedule I (CA) Schedule II (US)
Dosage Tablet taken 2-3 times daily, 4-6 hours apart - dosages vary. Extended release ("XR") capsules taken once daily - XR capsules available in 10 mg, 20 mg and 30 mg. One capsule a day – dosages vary from 30 mg to 70 mg
Off-label use Depression, obesity, sleep cycle disorders Depression, schizophrenia, excessive daytime sleepiness, binge eating disorder.
Addictive? Yes Yes, but less addictive as compared to Adderall.
Routes Oral, Insufflated, Intravenous Oral
Manufacturer Shire Shire
Effect Increases amount of dopamine and norepinephrine between synapses in the brain. Increases amount of dopamine and norepinephrine between synapses in the brain to more normal levels.
Pregnancy cat. C (US) C
Side effects Weight loss, insomnia, headaches, irritability, increased muscle tension, anxiety, increased heart rate, increased blood pressure, dry mouth, reduced efficacy over time. Slows physical growth in childhood. Discomfort, erectile dysfunction, dizziness, restlessness, nausea, dry mouth, anxiety, diarrhea, vomiting, headache, insomnia, weight loss, irritability, euphoria, upper abdominal pain, rapid heartbeat.
Restrictions Should not be taken during pregnancy or alongside MAOIs Should not be taken during pregnancy or alongside MAOIs.
Refillable? No No
Generic Available? Yes No

Uses

Both Adderall and Vyvanse increase the amount of dopamine and norepinephrine between synapses in the brain, which is useful for several medical conditions.

Adderall, which is used to treat ADHD and narcolepsy, is also sometimes prescribed for depression, obesity, and sleep cycle disorders. Vyvanse is used to treat ADHD in individuals ages 6 and older. Doctors are also researching its effectiveness at treating depression, schizophrenia, excessive daytime sleepiness, and binge-eating disorders. While more research is necessary, there is some evidence that both drugs may prove useful as smoking cessation aids.[1]

Efficacy

Numerous studies have been carried out on Adderall and Vyvanse regarding their efficacy and safety. Compared to placebo, children are much more likely to remain focused in school when taking these drugs.[2]

Famous blogger and psychiatrist Scott Siskind writes that his patients have found Vyvanse to be more effective:

My patients love Vyvanse. I try hard to convince people to take older, less expensive medications unless they're absolutely sure that the newer flashier one works better, but my patients are very convinced Vyvanse works better than Adderall.

Siskind hypothesizes this is due to two factors:

  1. Vyvanse is lisdexamphetamine i.e, dexedrine attached to a random inactive molecule called lysine. The stimulant does not work as long as the lysine is attached. The body removes lysine at a slow, consistent rate, so patients get a slow, consistent release of stimulant into their bloodstream. This timed-release mechanism makes it "smoother".
  2. The active ingredient in Vyvanse is dexedrine, which is a very effective stimulant. Patients have consistently rated Dexedrine higher than Adderall.

The timed release mechanism also makes Vyvanse less addictive. Overall, Adderall and Vyvanse are both effective at treating ADHD in children and adults and are generally well-tolerated, even up to daily doses of 70 mg.[3]

Dosage

Adderall is available in either tablet or extended-release capsule form. The tablets should be taken 2-3 times every day at 4-6 hour intervals. For individuals aged 6 or over, dosage begins with 5 mg once or twice daily and can be increased by increments of 5 mg every week. The dose rarely exceeds 30 mg. The capsule is taken once a day in the morning and should be swallowed whole, or opened and the contents sprinkled on apple sauce. Adults taking the capsule usually receive a dosage of 20 mg a day, while children and adolescents usually start with 10 mg a day before the dosage is increased.

Vyvanse is a single capsule taken once in the morning, with or without food. It can either be swallowed whole or opened and sprinkled into water. The recommended starting dose is 30 mg a day, but this may be increased by increments of 10 mg or 20 mg a week up to a maximum of 70 mg a day.

A comparison of popular ADHD medications Focalin, Vyvanse, Adderall, and Ritalin.
A comparison of popular ADHD medications Focalin, Vyvanse, Adderall, and Ritalin.

Side Effects

Adderall may cause a temporary decrease in growth rate but does not affect eventual adult height. It may decrease appetite, leading to weight loss. It can cause insomnia, headaches, increased muscle tension, irritability, and anxiety, as well as an increased risk of cardiac problems.

A 2010 study has found that treatment with Vyvanse led to statistically significant reduction in expected height, weight and BMI.[4] It may cause discomfort, erectile dysfunction, dizziness, restlessness, nausea, dry mouth, anxiety, diarrhea, vomiting, headache, insomnia, irritability, upper abnominal pain, and a loss of appetite.

Restrictions

Adderall should not be taken during early pregnancy or within two weeks of taking any MAOI medication. It causes a risk of serotonin syndrome when combined with SSRIs like Prozac, Zoloft or Lexapro.

Vyvanse also should not be taken during pregnancy or within two weeks of taking any MAOI medication.

Withdrawal

Adderall is a habit-forming drug. When an individual stops taking Adderall, they may experience extreme fatigue, insomnia, irritability and mental depression.

Vyvanse was designed to be less addictive than Adderall, but still has withdrawal side effects if abused, including exhaustion, depression, mood swings, heart irregularities and psychosis.

Abuse

Adderall and Vyvanse are both often used by college students to increase concentration. Adderall is more commonly used than Vyvanse.

Selling or giving away Adderall or Vyvanse without a prescription is a felony.

Popularity

According to a 2013 drug trend report, Adderall is, by far, the most popular of the stimulant drugs. However, compared to Adderall, which was approved by the FDA in 1996, Vyvanse, approved in 2008, has gained its popularity very rapidly.

ADHD drug market share in the U.S., 2013

References

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