Are There Risks of Long-Term Damage From Abusing Vyvanse?

Vyvanse pills
Vyvanse (lisdexamfetamine dimesylate) is a prescription stimulant medication primarily used to treat ADHD (attention-deficit hyperactivity disorder) in both adults and children and to treat moderate to severe binge eating disorder.1 People generally take one Vyvanse pill each day, usually in the morning.2

Vyvanse is designed in a way that provides a measure of protection against abuse. However, abuse is still possible. Some may misuse the drug to enhance cognitive performance—for example, while studying.

Long-term effects of abuse can include addiction, heart problems, psychosis, paranoia, and seizures.

Vyvanse’s Abuse Potential

Unlike other drugs that treat ADHD, including Ritalin and Adderall, Vyvanse’s unique chemical design means that it is activated in the body in a different way than other stimulant drugs.

Vyvanse is classified as a prodrug. These substances are chemically modified versions of pharmaceuticals that must first undergo an enzymatic conversion to become an active form of the drug.3

Even though an abuse deterrent has been engineered into the medication, some potential for Vyvanse abuse exists.

When someone is looking to amplify the effects of a drug, especially prescription drugs with extended-release mechanisms, one of the most common methods used to enhance the “high” is to crush a pill or open a capsule and snort the powder or dissolve it in a solution for needle use.

But because Vyvanse requires a rate-limited step of enzymatic conversion to become active amphetamine, it may be harder for users to achieve the desired surge of euphoria, even if they snort or inject it.3 In fact, a study in the Journal of Psychopharmacology found that when Vyvanse was administered via injection in doses as high as 50mg, it did not produce significant euphoric effects. On a “drug likability” scale, subjects felt a much greater drug-like “rush” from d-amphetamine than from Vyvanse. The study also noted that it was very difficult to extract the active amphetamine from the product through crushing.4

This could, therefore, discourage people from abusing it. The journal Pharmacy and Therapeutics noted that Vyvanse’s structure as a prodrug may offer a lower potential for abuse and reduces the risk of food or drug interactions. It is also the only stimulant with FDA-approved abuse-deterrent labeling.5,6

Despite this, lisdexamfetamine remains an amphetamine stimulant. Even though an abuse deterrent has been engineered into the medication, some potential for abuse of Vyvanse exists—primarily by ingesting larger than prescribed doses.

Signs of Vyvanse Abuse

Signs that someone may be abusing Vyvanse include:7

  • Dilated pupils.
  • Sweating.
  • Flushed skin.
  • Reduced appetite.
  • Stomach pain.
  • Vomiting.
  • Hyperactivity.
  • Restlessness.
  • Insomnia.
  • Shaking.
  • Poor coordination.
  • Anxiety.
  • Hostility.
  • Suicidal or homicidal thoughts.

An overdose of Vyvanse can include symptoms such as:2

  • Fever.
  • Nausea.
  • Vomiting.
  • Diarrhea.
  • Stomach cramps.
  • Muscle aches.
  • Weakness.
  • Restlessness.
  • Tremors.
  • Hallucinations.
  • Confusion.
  • Aggression.
  • Panic.
  • Rapid breathing.
  • Fast or irregular heart rate.
  • Loss of consciousness.
  • Coma.

Ingesting a large amount of Vyvanse can potentially be fatal and lead to seizures and heart failure.8

Long-Term Risks of Abuse

Although Vyvanse is somewhat more difficult to abuse than other prescription stimulant drugs, it’s not impossible. By taking more than the recommended dose, users can experience a range of serious, negative impacts on their health in the long run.

For example, misuse of central nervous system stimulants such as Vyvanse can hasten the development of tolerance, physiological dependence, and addiction. Some degree of tolerance and dependence may develop even in people who take the drug as prescribed.

  • With tolerance, the drug’s effects become less pronounced over time. Someone who has built tolerance to a drug may require higher and higher doses to achieve the desired effect.
  • Dependence means a person’s system adapts to the presence of the drug and only functions normally when the drug is present. When the person stops taking the drug, they can experience withdrawal symptoms.
  • Addiction is compulsive, drug-seeking behavior that may interfere with several aspects of the person’s life, such as their health, job, and relationships.7,8

Vyvanse withdrawal symptoms can include:9

  • Excessive sleeping.
  • Fatigue.
  • Mood swings.
  • Depression.
  • Overeating.
  • Cravings.

Other serious long-term effects of Vyvanse misuse, some of which may be associated with fatalities, include:8,10

  • Chronically elevated blood pressure.
  • Heart palpitations and arrhythmias.
  • Chest pains/heart attack.
  • Stroke.
  • Seizures.
  • Psychotic features—hallucinations, paranoia, delusions.
Misconceptions About ADHD Medications
hand next to spilled pill bottle Unfortunately, abuse of ADHD medications is widespread, especially among young people.

Many students who do not have ADHD take stimulant medications with the belief that the drugs will improve their academic performance or augment their cognitive skills. Studies have found that the rate of prescription stimulant abuse among college students is as high as 17%.11 Another study done by a researcher at the University of Kentucky found that 30% of the students at that school had misused ADHD medications to help them study.12

The Monitoring the Future (MTF) survey tracks middle and high school students, studying their behaviors, actions, and attitudes in a wide variety of areas. In 2018, MTF researchers determined that 1.8% of 8th graders, 4.1% of 10th graders, and 4.6% percent of 12th graders had misused Adderall at some point in their lives.13

Despite misuse to enhance cognitive performance, evidence is mixed on whether these drugs actually improve performance.

  • One study found that stimulant medications can improve some cognitive functioning in people who do not have ADHD.14
  • Another study found that the drugs can improve cognitive deficits, such as in memory, but not performance. And they do not increase IQ.15
  • Finally, a 2018 study found that Adderall have little impact on cognitive performance in non-ADHD college students.16

If you or someone you know is abusing Vyvanse, talk to your doctor or consider getting help at a drug rehabilitation program. Quitting the drug can prevent long-term effects on your health and help you avoid potentially severe consequences, such as overdose.

Sources

[1]. National Alliance on Mental Illness. Amphetamine (Vyvanse).

[2]. U.S. National Library of Medicine, Medline Plus. (2016). Lisdexamfetamine.

[3]. Gudin, J, and Nalamachu, S. (2016). An overview of prodrug technology and its application for developing abuse-deterrent opioids. Postgraduate Medical Journal, 128(1), 97-105.

[4]. Jasinski, D. and Krishnan, S. (2009). Human pharmacology of intravenous lisdexamfetamine dimesylate: abuse liability in adult stimulant abusers. Journal of Psychopharmacology, 23(4), 410-418.

[5]. Goodman, D. (2010). Lisdexamfetamine Dimesylate (Vyvanse), A Prodrug Stimulant for Attention-Deficit/Hyperactivity Disorder. Pharmacy and Therapeutics, 35(5), 273-276.

[6]. Simon, K, Worthy, S., Barnes, M., and Tarbell, B. (2015). Abuse-deterrent formulations: transitioning the pharmaceutical market to improve public health and safety. Therapeutic Advances in Drug Safety, 6(2), 67-79.

[7]. Food and Drug Administration. (2017). VYVANSE (lisdexamfetamine dimesylate) capsules, for oral use, CII.

[8]. National Institute on Drug Abuse. (2018). Prescription Stimulants.

[9]. Government of South Australia. Amphetamine Withdrawal Management.

[10]. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[11]. Reynolds, J. (2017). Why Its Risky for College Kids to Take ADHD Meds to Help Them Study. U.S. News and World Report.

[12]. Cooper, A. (2011). College students take ADHD drugs for better grades. CNN.

[13]. National Institute on Drug Abuse. Monitoring the Future Study: Trends in Prevalence of Various Drugs.

[14]. Baggot, K. and Kaminer, Y. (2014). Efficacy of stimulants for cognitive enhancement in non-attention deficit hyperactivity disorder youth: a systematic review. Addiction, 109(4), 547-557.

[15]. Lakhan, S. (2013). Prescription Stimulants in Individuals with and without ADHD – Do They Improve Cognition? Neurology, 80(7).

[16]. Weyandt, L. (2018). Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students. Pharmacy, 6(3), 58.

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About the editor
Dan Wagener is a Senior Web Content Editor at American Addiction Centers.
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