Key takeaways
Vyvanse is used to treat ADHD in adults and children, and binge eating disorder in adults. Vyvanse is not recommended during pregnancy or breastfeeding.
Common side effects of Vyvanse include insomnia, loss of appetite, increased heart rate, and irritability, among others, without a significant difference between genders.
Vyvanse may enhance executive functions in menopausal women according to a study, but its use for this purpose is considered off-label and not FDA-approved.
To minimize adverse effects of Vyvanse, it is advised to work with a healthcare provider on dosage, limit caffeine intake, be cautious of food and drug interactions, and monitor for cardiac side effects.
Vyvanse is a brand-name prescription medication used in the treatment of attention-deficit hyperactivity disorder (ADHD) and in binge-eating disorder (BED). Vyvanse is considered a central nervous system stimulant (CNS) drug and is a controlled substance. It is composed of lisdexamfetamine dimesylate, which is converted in the body to dextroamphetamine, an active ingredient in many other prescription stimulants. When used as an ADHD medication, it can be used in patients 6 years and older as a part of a multi-disciplinary approach including psychological, educational, and social interventions. Vyvanse use in treating BED is limited to adult use only, and only up to the age of 55 years. It is not to be used for a weight loss drug or to treat obesity. There are many positive outcomes associated with Vyvanse therapy, and your doctor can help decide if it is an appropriate choice for you.
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ADHD and binge eating disorders in women
The National Institutes of Health (NIH) report statistics on the prevalence of ADHD. As children, females are less likely than males to be diagnosed with ADHD than males. In fact, males are more than twice as likely to have ADHD as children than females. In adulthood, the prevalence is more similar (females 3.2% versus males 5.4%), but males are still more likely to be diagnosed with ADHD. In children, ADHD symptoms will present with hyperactivity and impulsivity. This is true in adults as well, but it may manifest as extreme restlessness or irritating others with constant activity. Vyvanse in adult women will improve focus and control behaviors associated with ADHD.
Binge eating disorder is characterized by recurring episodes of eating large amounts of food. The NIH reports it as the most common eating disorder, and unfortunately, many patients with severe binge eating disorder are also overweight or obese. Patients will often eat when they aren’t hungry, eat until they are uncomfortably full, feel shame and eat alone, and frequently but unsuccessfully diet. BED affects 1.25% of adult women and is much more common in women than men. Vyvanse does cause appetite suppression, and therefore is useful for some women in the treatment of BED. It is important to note that Vyvanse is not used for weight loss or the treatment of obesity but to limit the impulse to overeat.
What are common Vyvanse side effects in females?
The possible side effects of Vyvanse or any stimulant drug can vary from person to person, irrespective of gender. One of the debates among Vyvanse users is whether it causes hypersexual thoughts and impulses. There have been studies documenting that children with ADHD are more likely to participate in risky sexual behaviors and more frequent sexual activity as adults. This has mostly been studied in men. There seems to be a lack of anything conclusive linking this phenomenon to Vyvanse or gender.
The most common side effects of Vyvanse are:
- Insomnia
- Loss of appetite
- Increased heart rate
- Upper abdominal pain
- Irritability
- Vomiting
- Weight decrease
- Nausea
- Dry mouth
- Dizziness
- Constipation
Does Vyvanse affect your personality?
Vyvanse may lead to a change in behaviors for patients. Initially, patients taking Vyvanse may have insomnia (trouble sleeping) and become irritable. While this will likely decrease over time, persistent or worsening insomnia or irritability could be a sign that your dose is too high. Discuss these concerns with your prescribing doctor.
Does Vyvanse make you emotional?
Vyvanse may make you irritable and less able to adapt to your situation well at times. This can come across as an emotional response to those around you.
Is weight gain a side effect of Vyvanse?
No, in fact, weight loss is more typical in women. Younger females may have their growth stunted if using stimulants for long periods of time.
Is hair loss a side effect of Vyvanse?
The manufacturer indicates rare reporting of alopecia with Vyvanse use. You likely will not experience hair loss with Vyvanse, but if you do and it concerns you, you should speak with your healthcare professionals.
Vyvanse and pregnancy
All stimulants, including Vyvanse, should be avoided in pregnancy if possible. There is not sufficient data to say that Vyvanse is safe to take in pregnancy. There is an increased risk of birth defects and premature delivery or miscarriage when the mother takes stimulants in pregnancy. Amphetamine drugs such as Adderall and Ritalin are lipid-soluble and can cross the placenta. Vyvanse does not affect your ability to become pregnant, and if you discover you are pregnant you should stop taking it immediately and let your doctor know. If you are planning to become pregnant, discuss with your doctor ahead of time. Ideally, you would stop Vyvanse and find safer pregnancy methods to treat ADHD or BED before becoming pregnant. Your ADHD could get worse during pregnancy if you don’t work with your doctor to find other suitable ways to cope with the symptoms of ADHD while pregnant.
Vyvanse while breastfeeding
Breastfeeding is not recommended while taking Vyvanse or any other stimulants. Vyvanse and its metabolite, dextroamphetamine, do cross into the breast milk. Long-term neurological and developmental effects on infants are unknown because they are not well studied.
If a stimulant is administered while breastfeeding, you would want to watch for signs of insomnia, irritability, and decreased appetite. Vyvanse can stay in your system for up to two and a half days. High doses of amphetamine stimulants can decrease milk supply, especially in those who may already be struggling with supply challenges. The American College of Obstetrics and Gynecology (ACOG) makes no specific accommodations for taking Vyvanse while breastfeeding such as “pumping and dumping.”
There are alternatives to utilizing Vyvanse while breastfeeding. These include cognitive, behavioral therapy as well as dose and regimen adjustments. Your doctor will provide you with the best alternatives to suit your diagnosis.
Vyvanse for menopause
Menopausal women have reported increasing difficulty with executive functions in the early stages of menopause. Executive functions are comprised of things such as memory, cognitive flexibility, inhibitions, and attentional control. A randomized, controlled trial evaluated Vyvanse in menopausal women and its impact on executive functions. This study utilized the Brown Attention Deficit Disorder Scale (BADDS) in a double-blind, placebo-controlled, cross-over fashion. They looked at total score and subset scores related to verbal memory and working memory tasks. The Vyvanse group was found to have significantly higher scores than the placebo group in 4 of the 5 scale subsets, particularly in recall. This indicates that Vyvanse may play a role in symptom improvement related to executive functions in menopausal women.
The mechanism by which Vyvanse affects these functions is not fully understood. This indication is not approved by the Food and Drug Administration (FDA), and its use in menopause, for this reason, is considered “off-label.” The women in the study referenced above did exhibit increased blood pressure while taking Vyvanse, though it remained within normal range and would not constitute a diagnosis of high blood pressure. Vyvanse does not appear to play a role in hot flashes. Your doctor can provide you with additional drug information and help you decide if Vyvanse treatment is appropriate for you in menopause.
How to take Vyvanse to avoid side effects
1. Work with your provider to find the right dose
Vyvanse is available in two formulations and has a variety of strengths. The chewable tablet is available in 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, and 60 mg. The oral capsule is available in 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, and 70 mg. Most adults start around 30 mg once daily and can go up in small intervals to the max dose of 70 mg. Moving the dose slowly allows your practitioner to see if the dose is working for you while not causing unwarranted adverse effects from a dose that is too high.
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2. Limit caffeine
Limit intake of caffeine to avoid compounding side effects like nervousness, irritability, nausea, insomnia, and tremor. Caffeine is commonly found in coffee, teas, sodas, chocolate, and dietary supplements.
3. Avoid certain foods
There are food interactions that can alter the way Vyvanse works with your body. You should avoid drinks that make your urine more acidic like cranberry juice because it speeds up the excretion of Vyvanse from your body. Diets high in dairy or spinach may do the opposite and slow down excretion of the drug. To avoid fluctuations in Vyvanse’s effectiveness, you should maintain a relatively steady intake of dietary elements.
4. Be aware of drug-drug interactions
The prescription weight-loss drug phentermine should not be taken with stimulant medications like Vyvanse as they may exacerbate some of the same symptoms that caffeine does. If you are currently taking one of the selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, your risk for Vyvanse side effects increases as well as the risk for serotonin syndrome. This can present with hallucinations, confusion, headache, and diarrhea. This risk is true of many antidepressants, so you should talk to your doctor before starting Vyvanse.
Patients who have bipolar disorder, psychosis, depression, and other mental health disorders should be evaluated prior to beginning Vyvanse therapy. Vyvanse may interact with other prescription drugs commonly used in these conditions and lead to an increase in suicidal thoughts. Always speak to your doctor about current medications you are taking to avoid possible drug interactions.
5. Call your provider about cardiac side effects
Heart and cardiovascular disease are some of the most common causes of death in women. Women should monitor for increased heart rate, chest pain, and signs of circulation problems like cold or numb extremities while on Vyvanse. Patients with a history or family history of high blood pressure, heart attack, heart disease, or other related medical conditions related to heart problems should speak with their healthcare provider before beginning Vyvanse as sudden death could occur.
6. Do not suddenly stop taking Vyvanse
This is not intended to encompass everything you may need to know before taking Vyvanse or making a change to your therapy. Sudden discontinuation could lead to withdrawal symptoms and serious side effects as well. Speak to your physician before stopping or making changes to your Vyvanse regimen.