Vyvanse Delivery System
Lisdexamfetamine (Vyvanse) uses an unusual drug delivery system to get the stimulant dextroamphetamine into a person’s blood stream at a fairly steady rate over a period of eight to ten hours. It is interesting to know why and how the new delivery system was developed.
The more rapidly a stimulant gets into the blood stream, the higher and more excited, even high, a person can get on it. For most people, taking a stimulant by mouth gets medication into their blood stream fairly slowly, so few people get high on it. But some people grind up these medications, then sniff them or inject them into their veins. They got high, but some died of overdose. Scientists have searched for a way to prevent this from happening.
A few years ago, someone invented a process that makes some medications inactive by bonding the amino acid lysine to them. Only after the bond between the lysine and the medication is broken does the medication become active, that is, have its effect.
If someone grinds up a medication bound to lysine and sniffs or injects it, they would not get high. But if the person swallows it, intestinal enzymes and red blood cell enzymes break the bond between the medication and the lysine, thereby activating the medication.
Vyvanse consists of dextroamphetamine bonded to the amino acid lysine. When a Vyvanse pill is swallowed, enzymes in the gut and on the red blood cell split the lysine away from the dextoramphetamine, which then becomes active. An unexpected benefit of this system is that the dextroamphetamine is released into the blood stream very steadily and works smoothly during a period up to ten hours or so after it is taken.
Vyvanse acts more smoothly and over a longer period of time than do other long acting ADD medications. In my experience, it sometimes appears to have a slightly stronger effect than Adderall, which in turn has a slightly stronger effect than Ritalin or Concerta for many people. For these reasons, it is usually my first choice of medications to treat ADD. However, it is somewhat more likely than other stimulants to interfere with sleep especially during the first few days it is taken. There is some evidence that some people adjust to this effect if they are able to get through the first week or so with less sleep than usual.
The major downside of Vyvanse is that it is expensive compared to the generics, though it is not very different in price from Adderall XR. If your insurance covers all but a small co-pay, that may not be an issue. But some insurance companies require a larger co-pay for Vyvanse than for other stimulants, and some people don’t have medication insurance coverage. In addition, perhaps because it is more expensive, some insurance companies require that the prescribing clinician submit a prior authorization request justifying its use and dosage.
Some people have reported that the cost of Vyvanse is lower at Costco or Xpect Discount pharmacies than at other pharmacies.
