*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
*An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.
Vyvanse and Adderall XR are stimulants FDA-approved to treat attention-deficit hyperactivity disorder (ADHD). One may be better than the other in certain circumstances. Vyvanse and Adderall XR have similarities but cannot be directly substituted for one other. Adderall XR comes in a generic or brand name, a short-acting, and a long-acting version. Vyvanse only comes in a brand name that is a long-acting formula.
If you’re considering Vyvanse or Adderall, or want to discuss your current prescription with a provider, you will be limited in your options. Circle Medical is an online psychiatry platform that can and will prescribe stimulant medications, which are controlled substances. This platform can connect you with a provider quickly and offer assessments and prescription consultation.
Boxed Warning: Lisdexamfetamine dimesylate (Vyvanse) – Risk of medication misuse or abuse
Lisdexamfetamine dimesylate, the active ingredient in Vyvanse, has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Lisdexamfetamine dimesylate has a risk of misuse (abuse) which can lead to dependence on the medication.
Vyvanse is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
Boxed Warning: Amphetamine, dextroamphetamine mixed salts (Adderall) - Risk of medication misuse or abuse
Adderall has a black box warning. These are the most serious types of warnings from the Food and Drug Administration (FDA). Amphetamines, an active ingredient in Adderall, have a risk of misuse (abuse) which can lead to dependence on the medication, serious heart conditions, and even sudden death.
Adderall is a controlled substance, which means that it’s more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
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What Is Vyvanse?
Vyvanse is FDA-approved to treat ADHD and binge-eating disorder (BED). Vyvanse contains the active ingredient lisdexamfetamine dimesylate and it is classified as a class II or schedule II controlled substance. This means the medication has a high potential for abuse and dependence. The exact way that Vyvanse works is unknown but it is known that Vyvanse changes certain chemicals in the brain, which creates a feeling of motivation to take action to reach a certain goal. The changes in levels of these chemicals also affect appetite and the urge to binge eat.1
What Is Adderall XR?
Adderall XR is FDA-approved to treat ADHD. Adderall (non XR) is no longer available as the brand name but it was also FDA-approved to treat narcolepsy. Narcolepsy is a sleep disorder that makes people very drowsy during the day. Adderall XR contains mixed amphetamine salts and it is classified as a class II or schedule II controlled substance, which means this medication has a high potential for abuse and dependence. Adderall XR works by changing certain chemicals in the brain, which creates a feeling of motivation to take action to reach a certain goal.2 It’s important to note that all Adderall immediate-release tablets have been discontinued as the brand name. Adderall is only available in an extended-release version known as Adderall XR. Adderall XR is only approved to treat ADHD. This article will be focusing on Adderall XR.
How Are Vyvanse & Adderall XR Similar?
Adderall XR and Vyvanse are both FDA-approved stimulants to treat ADHD. Adderall XR and Vyvanse can be prescribed by licensed professionals who have continued their education on ADHD and mental health. These include physicians (including psychiatrists, pediatricians, family doctors, and neurologists) and nurse practitioners (NPs).
Similarities between Vyvanse & Adderall XR include that they are both:1,2,3
- Prescription-only medications
- Capsule dosage form (may be opened and sprinkled on food)
- Stimulant medications
- Have multiple uses as FDA-approved and non-FDA-approved treatments
- Controlled substances in the Schedule II category, meaning these drugs have a very high risk for abuse
- Have similar side effects
- Taken with or without food
Key Differences Between Vyvanse & Adderall XR
Adderall XR and Vyvanse are both medications for ADHD, but they are not interchangeable. If a patient has problems with sleep, appetite loss, or anxiety Vyvanse may be a better option than Adderall XR.1,2
The key differences between Vyvanse and Adderall XR are:1,2,3,4
- Approval date: Adderall XR was approved for use in 1996; Vyvanse was approved for use in 2007.
- ADHD approval age range: Adderall XR and Vyvanse are approved for children aged 6 and older.
- Active ingredients: Adderall XR is a mixture of four different kinds of amphetamine salts (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate), while Vyvanse only contains one type of amphetamine salt (lisdexamfetamine).
- FDA approval: Both medications are approved for the treatment of ADHD
- How they work: Both Adderall XR and Vyvanse are stimulants. However, Adderall XR releases the drug immediately upon swallowing, whereas Vyvanse is a prodrug. This means that Vyvanse is inactive until it is converted into dextroamphetamine when inside the body.
- How long they work: Adderall XR lasts 8 to 12 hours. Vyvanse lasts up to 8 hours.
- Abuse potential: Adderall XR and Vyvanse have the risk for abuse. However, Vyvanse has a lower risk of abuse compared to Adderall XR. Vyvanse is a prodrug and has a slower onset of action, and it has to metabolize in the body, which means it is not effective when it is inhaled, snorted, and injected, like Adderall XR.
- Brand/Generic form: Adderall XR is available in generic form, which may be a cheaper option. Vyvanse is only available as the brand name.
Conditions Treated
Vyvanse and Adderall XR differ in the FDA-approved and off-label conditions they treat. An FDA-approved drug means that the drug has been reviewed by the drug and is determined to provide benefits that outweigh its known and potential risks for the intended population. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.1,2,3
While both medications are FDA-approved to treat ADHD, their other approved uses differ significantly. Adderall XR’s other approved use is for narcolepsy, whereas Vyvanse is approved for binge eating disorder. Off-label, both can be used to treat depression symptoms. Adderall XR has off-label use as a treatment for anxiety, and Vyvanse may be used for schizophrenia.
Standard Dosages & Forms
Adderall is available as immediate-release (generic) and extended-release (XR), while Vyvanse is available in extended-release (long-acting) form. Adderall is available in oral tablets and capsules, while Vyvanse is available in oral capsules and chewable tablets.1,2,3
Adderall doses & forms include:2
- Adderall XR capsules: 5mg, 10mg, 15mg, 20mg, 25mg, 30mg
Vyvanse doses & forms include:1,5
- Vyvanse oral capsules: 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, and 70mg
- Vyvanse chewable tablets: 10mg, 20mg, 30mg, 40mg, 50mg, and 60mg
Strength
For Adderall XR, in patients 6-17 years of age, starting dose is 10 mg once daily in the morning, and the provider may increase it by 5 mg or 10 mg at weekly intervals up to the maximum recommended dosage of 30 mg once daily. For adults, the recommended dose is 20 mg once daily in the morning.
The recommended starting Vyvanse dosage in patients 6 years and older is 30 mg once daily in the morning and the provider may increase it by 10 mg or 20 mg at weekly intervals up to the maximum recommended dosage of 70 mg once daily.
Doses of Adderall XR and Vyvanse are not interchangeable. The provider will assess your symptoms and adjust doses as necessary. Do not try to adjust doses on your own, do not let others take your medication, and do not take others’ medication.
How Long It Takes to Work
After taking Adderall XR, it starts to work within one hour. The time to reach maximum effect is about 7 hours, and it typically lasts up to 8 to 12 hours.2,3
After taking a Vyvanse capsule, it starts to work within one hour, but the effect could be delayed if taken with food. The maximum effect is reached at about 4-5 hours. Vyvanse typically lasts up to 8 in the system.1
Addiction Potential
Misuse of Adderall XR and Vyvanse can lead to addiction in severe cases. Long-term use of stimulants can cause a person to develop a tolerance, meaning one will need higher and/or more frequent doses of the drug to get the same effects. If one were to immediately stop Adderall XR or Vyvanse after being on a high dosage for a long period, withdrawal is likely to happen. Withdrawal symptoms include extreme tiredness, mental depression, and difficulty sleeping.
The half-life of a drug is the time it takes for the amount of a drug in your body to reduce by half. Adderall XR’s half-life is about 10 to 14 hours. Vyvanse’s half-life is about 9 to 11 hours. It takes about 5 half-lives for a drug to be considered eliminated from the body.
The table below summarizes the key differences between Vyvanse versus Adderall XR:1,2,3,5
| Key Components | Vyvanse | Adderall XR |
|---|---|---|
| What is the generic name? | Lisdexamfetamine | Dextroamphetamine and amphetamine salts |
| What forms does it come in? | Capsule and chewable tablets | Capsules |
| What are the typical dosages? | Capsules: 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, and 70mg Chewable tablets: 10mg, 20mg, 30mg, 40mg, 50mg, 60mg | Capsules: 5mg, 10mg, 15mg, 20mg, 25mg, 30mg |
| Who is approved to take it? | ADHD •Adults and pediatric patients 6 years and older BED •Adults (over 18 years) | ADHD •Adderall XR: Adults and children 6 years or older |
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What Are Vyvanse & Adderall XR Used to Treat?
Vyvanse and Adderall XR differ in the FDA-approved and off-label conditions they treat. An FDA-approved drug means that the drug has been reviewed by the drug and is determined to provide benefits that outweigh its known and potential risks for the intended population. An off-label use of a medication is a use that is not FDA-approved. Prescribers can decide to use a medication off-label because, in their professional judgment, they believe it may offer a benefit to someone.1,2,3
Adderall XR is commonly used as an FDA-approved medication to treat disorders such as:2,3
- Adderall XR: Attention-deficit hyperactivity disorder (ADHD) in children 6 years or older and adults
Vyvanse is commonly used as an FDA-approved medication to treat disorders such as:1
- Attention-deficit hyperactivity disorder (ADHD) in children 6 years or older and adults
- Binge eating disorder (BED) in adults
The table below compares the medical and mental health conditions Vyvanse and Adderall XR are used to treat:
| Condition | Vyvanse | Adderall XR |
|---|---|---|
| ADHD | FDA-approved | FDA-approved |
| Binge eating disorder | FDA-approved | No |
| Depression | Off-label | Off-label |
| Anxiety | No | Off-label |
| Schizophrenia | Off-label | No |
Side Effects of Vyvanse & Adderall XR
Vyvanse and Adderall XR are both stimulants and can cause similar side effects affecting the heart, GI, and nervous system. Side effects such as increased blood pressure is more common in Adderall XR than Vyvanse and is worse with a higher dosage. Decreased appetite and trouble sleeping are common side effects for both medications but can usually be managed with the timing of the dose.1,2,3
Certain risk factors and the use of Adderall XR or Vyvanse with other medications can increase the risk of psychiatric and behavioral effects and serotonin syndrome, which includes agitation, hallucinations, or tremors. Some commonly experienced side effects are often mild and can be managed, while a small percentage of patients may experience side effects that will require medical attention.1,2,3
Here are common side effects of both Vyvanse and Adderall XR:1,2,3
- Dry mouth
- Constipation
- Diarrhea
- Headache
- Dizziness
- Increased blood pressure
- Abdominal pain
- Weight loss
- Decreased appetite
- Difficult to sleep
- Vision changes
You should talk with your prescriber and pharmacist about any potential side effects from either medication.
Warnings & Precautions for Vyvanse & Adderall XR
Adderall XR and Vyvanse have a potential for abuse and dependence. Serious heart-related events have occurred with stimulants like Adderall XR and Vyvanse. In children and teens, long-term decreases in growth may occur so growth should be monitored. If seizures or signs and symptoms of serotonin syndrome (agitation, hallucinations, or tremors) occur seek medical attention immediately. Blurry vision has also been reported with the use of stimulants.1,2,3
Risks to consider when taking Vyvanse and Adderall XR include:1,2,3,6,7
- Interactions with alcohol: Adderall XR and Vyvanse taken with alcohol can increase risk-taking behaviors and impair attention and reaction time.
- Use while pregnant or breastfeeding: Animal studies have shown that fetal harm can occur. It’s unclear if it is safe to take stimulants such as Adderall XR and Vyvanse while pregnant or breastfeeding. If you are pregnant or breastfeeding or planning to become pregnant, you should talk with your doctor about the possible risks and benefits of taking the medication.
- Allergic reactions: Although it is not common, allergic reactions such as hives, difficulty breathing, and swelling of the lips have occurred with Adderall XR and Vyvanse.
- Heart abnormalities or serious heart problems: Sudden death, stroke, or heart attacks can occur if you have pre-existing heart problems when starting Adderall XR and Vyvanse.
- History of substance use disorder: Adderall XR and Vyvanse should be avoided in patients with a history of substance use disorders.
- Psychiatric disorders: Adderall XR and Vyvanse can increase symptoms of pre-existing psychotic disorders, can cause a manic episode in patients with bipolar disorder, or cause psychotic or manic symptoms, including hallucinations and delusions.
Potential Drug Interactions With Vyvanse & Adderall XR
Adderall XR and Vyvanse use with other medications may cause these medications to be either more or less effective. Taking Adderall XR or Vyvanse with certain antidepressants can increase the risk for seizures and serotonin syndrome These potential interactions can be managed or prevented by your provider adjusting doses of your medication or avoiding certain medications.1,2,3
Taking certain medications, herbs, or supplements with Vyvanse and Adderall XR can change how these medications work in your body or increase the risk for serious side effects. This article does not consider all the possible interactions. Please let your doctor, psychiatrist, and pharmacist know about all the products you currently use, such as prescription medication, nonprescription drugs, and herbal supplements. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.
Medications and substances that have harmful interactions with Vyvanse and Adderall XR include:1,2,3
| Complicating Interactions | Vyvanse | Adderall XR |
|---|---|---|
| Tricyclic antidepressants | X | X |
| MAOIs | X | X |
| Serotonergic drugs | X | X |
| CYP2D6 Inhibitors | X | X |
| Alkalinizing agents | X | X |
| Acidifying agents | X | X |
| Proton pump inhibitors | X |
Tricyclic antidepressants: Used for depression. Increase high blood pressure effects.
MAOIs: Used for depression. Increase high blood pressure effects.
Serotonergic drugs: Used for depression. Increase the effects of Adderall XR and Vyvanse.
CYP2D6 Inhibitors: Used for schizophrenia and anxiety. Risk of seizures will increase.
Alkalinizing Agents: Used to increase the pH in the body. Increase effects of Vyvanse and Adderall XR.
Acidifying agents: Used in a to lower the pH in the body. Decrease effects of Vyvanse and Adderall XR.
Proton Pump Inhibitors: Used for heartburn. Decrease time to max effect of Vyvanse and Adderall XR.
Which Is Right for You: Vyvanse or Adderall XR?
The medication best for your needs can depend on many factors. You may need to consider online psychiatry services if seeing a doctor in person isn’t feasible. They can help you consider the benefits and risks of each medication. Adderall XR and Vyvanse work similarly, and neither is more convenient to take than the other since they are both dosed once daily. They share the same drug interactions, too, so neither should impact the other drugs that you take more than the other.1,3
The quality of life, daily functions, withdrawals due to adverse events, treatment discontinuation, serious side effects, hospitalization, heart side effects, and emergency department visits do not appear to differ between Adderall XR and Vyvanse.8,9
Since Vyvanse does not yet have a generic version on the market, it is currently more expensive than Adderall XR. Therefore, insurance companies may prefer Adderall XR to Vyvanse. However, a generic version of Vyvanse may come to the market in 2023.10,11
How to Get a Prescription for Vyvanse & Adderall XR
There are various ways to get prescribed Adderall XR, Vyvanse, or other ADHD medications. These medications are only available by prescription. As controlled medications, only certain types of healthcare professionals can prescribe Adderall XR and Vyvanse. These providers may vary by state laws. These include physicians (including psychiatrists, pediatricians, family doctors, and neurologists) and nurse practitioners (NPs). Patients must determine which type of provider is most appropriate to diagnose and treat their ADHD on an ongoing basis, weighed against who is available close to where they live.12
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Questions to Ask Your Health Team About Vyvanse & Adderall XR
Open communication between patients and doctors is vital for effective healthcare. When patients actively participate in their own care by openly expressing their questions, concerns, and expectations, it fosters a collaborative and trusting relationship with their healthcare provider. By sharing important information about symptoms, medical history, and lifestyle factors, patients allow providers to make well-informed decisions and provide tailored treatment plans.
Equally important is the role of patients in coming to appointments prepared with any questions or concerns they may have. This not only helps patients gain a deeper understanding of their condition and treatment options, but it also empowers them to actively engage in shared decision-making. Open communication and preparedness in healthcare settings enhance patient satisfaction, facilitate accurate diagnoses, and promote optimal health outcomes.
Questions to ask your prescriber about Vyvanse and Adderall XR include:
- Is it safe to take Vyvanse or Adderall XR with my other medications?
- Will Vyvanse or Adderall XR be covered by my insurance?
- Which one has the best results as a treatment for ADHD?
- Does my medical history increase my risk of side effects for either?
- How long can I expect side effects to last?
- How often should I see you for checkups while taking Vyvanse or Adderall XR?
- Are there any potential interactions with specific foods, beverages, or supplements that I should be aware of while taking Adderall XR or Vyvanse?
- How long does it typically take for Adderall XR or Vyvanse to start working, and what can I expect in terms of symptom improvement?
- How long is it recommended to continue taking Adderall XR or Vyvanse? Is there a specific duration of treatment, or is it an ongoing medication?
- Are there any specific precautions or considerations I should be aware of while taking Adderall XR or Vyvanse, such as driving or operating machinery?
- What are the potential risks or concerns associated with long-term use of Adderall XR or Vyvanse?
- Are there any alternative treatment options for ADHD that I should explore or consider?
- Is it safe to take Adderall and Prozac together?
- How does Adderall compare to Desoxyn and other stimulant medications?
In My Experience
In my experience, most of the patients I see are on generic versions of Adderall and Adderall XR due to insurance preferences. Vyvanse is also covered on insurance plans, but usually takes additional steps from the pharmacy and provider to get paid for by insurance so you may not be able to get the medication as soon as it is prescribed with these extra steps that are needed. Very few patients are on brand name Adderall and XR now, but some do require brand name Adderall due to side effects to some of the inactive ingredients in the generic versions.
It’s important to talk to your doctor about this topic and follow their guidance because it may take a few different tries to get the right medication and dose for you. Adderall XR and Vyvanse are effective medications when taken as prescribed by providers, but issues arise when patients start to take more than prescribed or take medication that isn’t prescribed specifically for them. If you think you need this medication and your provider will not prescribe you the medication, you may consider seeing another provider for a second opinion. If your provider determines you don’t need Adderall XR or Vyvanse, ask your provider about other options that would address your health concerns.
Additional Resources
To help our readers take the next step in their mental health journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy is compensated for marketing by the companies included below.
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Best Online Psychiatry Services
Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.
