Vyvanse is the new ADHD medication from Shire PLC, the makers of Adderall XR. It marks a significant change in the range of medication available as it uses a different type of stimulant than other medications, it a has long duration and it is especially formulated to prevent substance abuse.
How Vyvanse Works
The active substance in Vyvanse is lisdexamfetamine and is chemically very close to Dexedrine Spansules, a stimulant occasionally prescribed for ADHD. The advantage of lisdexamfetamine over methylphenidate (used in Ritalin and Concerta) is that it has a long lasting effect. Taken in the in the morning, the peak effectiveness last one to four hours but had a notable effect on symptoms for 12 hours.
Traditional ADHD medications have been easy to abuse and this has led to dependency problems. Vyvanse is a prodrug, a substance that is inert until it is digested. This mimics how the body creates useful chemical and vitamins from our food. As Vyvanse only acts as a stimulant once it is broken down by the stomach you cannot get a high from grinding it up and snorting it. Swallowing higher than prescribed doses (150mg compared to the recommend max of 70mg) will still produce a high indistinguishable from that produced by a comparable dose of Ritalin.
Vyvanse: Four Times More Side Effects
Because Vyvanse is new it has only been used by those adults and children who took part in the drug’s trials. In total, less than 1000 people. With such a small sample (compared to the millions who will end up taking the drug) there is very little first hand knowledge of the drugs effects. With each of the other major drugs, Ritalin, Adderall etc, different people can have very different reactions to the drugs. Someone who is fine on one drug may have numerous side effects from a chemically very similar drug. The body and brain are very complex chemical systems and stimulants are a very crude tool.
Currently we only have the Vyvanse prescribing information to go on as a guide to its effects but one things is very noticeable. In trials 10% of users stopped taking the drug due to adverse effects (i.e. side effects). This is much higher than Adderall where only 2.4% of participants were effected. In the Adderall trials more people stopped using the placebo than the real drug but for Vyvanse only 1% of placebo users dropped out. The new drug has a side effect rate 10 times higher than the base line and four times high than Adderall.
Vyvanse And The $1.5 Billion Goal
Shire PLC are introducing this new drug as a replacement for Adderall XR whose patent is running out. They hope to capture 50% of the market share with the drug and as the market is worth $3 billion, a 50% share will generate a lot of money. Expect to see a lot of advertising aimed at parents, not doctors, when Vyvanse is launched in July. In theory Vyvanse is a lot cheaper to make than competing drugs as its chemical formula is its key rather than the complex release mechanisms used by others drugs. However I expect that Vyvanse will retail at about the same as the other ADHD medications at about $130 – $150 for a months dose.