Adderall and Vyvanse are two of the more commonly prescribed drugs for the treatment of Attention-Deficit Hyperactivity Disorder (ADHD). Adderall, the more well known of the two, was first approved for use in 2001, Vyvanse received FDA approval in 2007.
Treatment for ADHD
ADHD is characterized by inattention, Hyperactivity, and Impulsivity.
Inattention is the inability to focus, lack of organization, abnormal social behavior, and forgetfulness of daily activities. Hyperactivity is generally seen in an inability to sit still, a frequent need to walk or move around, or excessive talking or restlessness. Impulsivity is the lack of patience, hard time waiting for one’s turn at an activity, or frequently interrupting or inappropriate conversation.
The purpose of these two medications is identical, to control the symptoms of ADHD. While there has been promising research showing certain common patterns of brain activity shared by those diagnosed with ADHD, there is no consensus on the cause of the condition.
Who Uses These Drugs
Patients that may benefit from these drugs are both children and adults. These drugs are most commonly used for those within the 10-19 year age range. The diagnosis of ADHD has almost exclusively applied to this age bracket. New research has identified evidence of ADHD among adults.
Due to the controversy surrounding ADHD, many adult sufferers may go untreated. There has been a great deal of public opinion backlash at the validity of the condition. Public opinion often dismisses the condition as something particular to a certain limited group in America and used as an excuse for bad behavior.
New research shows the condition to be prevalent worldwide across the spectrum of young children to adults. More clinical studies and increased awareness may help in identifying the cause of the condition and foster new, more effective treatments.
Adderall
Adderall was the first into the market as treatment for ADHD. Experience with long term usage of the drug has shown a high risk of addiction or potential for abuse. Vyvanse entered the market and showed a lower risk of abuse.
Adderall is a combination of dextroamphetamine and amphetamine. Vyvanse, the active ingredient is lisdexamfetamine. Both drugs have a potential for addiction and abuse, although Vyvanse offers a lower abuse potential.
According to the FDA, in 2011 there were 1.6 million prescriptions written for Adderall and 41. Million written for Vyvanse for patients aged 10-19.
Side Effects
The side effects of these drugs are similar. They include anxiety, diarrhea, dizziness, dry mouth, headache to name a few. There are more severe, although less common side effects such as hallucinations, increased heart rate, high blood pressure, and manic episodes.
The FDA has reported incidents of death resulting from the use of Adderall, as of the date of this article there have been no fatalities attributed directly to Vyvanse. There is an ongoing debate as to some reports of patients who were taking Vyvanse dying and the underlying cause. Addition research is needed.
The essential composition of the two drugs, both contain amphetamines, and the manner in which they are prescribed, are similar. Dosage for the most common form of Adderall is a pill taken two to three times a day. Vyvanse is taken as a single capsule taken once a day.
There is a new version of Adderall available which provides a longer acting dosage, reducing the frequency to twice daily.
Most of the research is neutral as to the difference in effectiveness between the two drugs. No definitive study exists that shows any significant effectiveness differences. The decision to prescribed either of the drugs is very much dependent on having a full
How Do They Differ?
The primary differences are the dosage frequency and potential for abuse which is a matter of the physician’s discretion. Understanding the type of patient, their general health, severity of symptoms, and potential for abuse are all required to make a sound decision on which drug to use.
Monitoring of the patient, once they begin treatment, is also critical. Awareness of the potential side effects, both moderate and severe, is critical to a successful result. Constant communication with the treating physician of any concerns or problems is important with both medications.
Based on this information, the following is a summary and comparison of the differences between the drugs.
Comparisons
Dosage:
Adderall: 3x per day
Vyvanse: 2x per day
Abuse Potential:
Adderall: High
Vyvanse: Moderate
Side Effects:
Adderall: Identical
Vyvanse: Identical
Risk of Death:
Adderall: Low
Vyvanse: Undetermined
Available Since:
Adderall: 2001
Vyvanse: 2007
Can You Die?
In terms of the most significant difference, the fact that Adderall has been linked to several deaths while Vyvanse has not is compelling. While Adderall has had a more widespread exposure, and thus more available evidence, Vyvanse was developed after much of the downside effects of Adderall had been identified.
Physicians have more clinical resources available to them to refine the diagnosis and select the appropriate method of treatment. The choice of treatment needs to be based on a variety of factors, which include a full explanation of the risk vs. benefit analysis to the patient’s parents or guardian.
Having the Right Treatment Plan
There also need be a clear determination of the goals of the treatment, the length of the evaluation period, and the effect the two options will have on the patient’s lifestyle.
With all these factors in mind, there is no comparative difference between the two medications. Each provides relief for the symptoms. Thus, the choice becomes more dependent on the treating physician to weigh that information against the known side effects and associated risk factors.
There is no easy answer. Both offer relief and risk. Choosing the right one is a difficult, but not insurmountable task. The debilitating effect of the condition warrants serious consideration of both medications.