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Although Lisdexamfetamine is referred to as “pro-drug” of dextroamphetamine, it is still an amphetamine, meaning that Lisdexamfetamine is easily abused and can cause insomnia, agitation, anxiety and sometimes psychotic symptoms like seeing things or becoming paranoid (seeing or hearing things that are not real, believing things that are not real, or are suspicious).

ABOVE: The Essential Guide to Psychiatric Drugs—Rev. and updated (2007); Kaplan and Sadock's Synopsis of Psychiatry (2007) citing American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.
Vyvanse

Lisdexamfetamine [Vyvanse] is not new, its active ingredient has been around since the 1920s.

Lisdexamfetamine Side Effects and Warnings

Schedule II Substance

Dextroamphetamine Composite

  • Brand Names: VYVANSE
  • Generic Name: LISDEXAMFETAMINE (dextroamphetamine with lysine)
  • Category: CEREBRAL STIMULANTS
Drug Enforcement Administration, Department Of Justice: Schedule II Controlled Substance

FDA “Black Box” Warning Label

The Food and Drug Administration (FDA) requires the following "black box" warning on all amphetamines, including Lisdexamfetamine, which means that medical studies indicate Lisdexamfetamine carries a significant risk of serious, or even life-threatening, adverse effects.

WARNING

AMPHETAMINES HAVE A HIGH POTENTIAL FOR ABUSE. ADMINISTRATION OF AMPHETAMINES FOR PROLONGED PERIODS OF TIME MAY LEAD TO DRUG DEPENDENCE AND MUST BE AVOIDED. PARTICULAR ATTENTION SHOULD BE PAID TO THE POSSIBILITY OF SUBJECTS OBTAINING AMPHETAMINES FOR NONTHERAPEUTIC USE OR DISTRIBUTION TO OTHERS, AND THE DRUGS SHOULD BE PRESCRIBED OR DISPENSED SPARINGLY.

MISUSE OF AMPHETAMINE MAY CAUSE SUDDEN DEATH AND SERIOUS CARDIOVASCULAR ADVERSE EVENTS.

ABOVE: FDA black box warning label means that medical studies indicate the drug carries a significant risk of serious or even life-threatening adverse effects. The bold warning label appears on the manufacturer's wholesale packaging and is the strongest alert the FDA can require of drug-makers.

Using amphetamines once is sufficient to induce some of these symptoms:

Short-Term Effects:

  • Enhanced mood and body movement
  • Increased wakefulness, physical activity
  • Increased respiration
  • Euphoria
  • Insomnia
  • Increased heart rate
  • Increased blood pressure
  • Reduced appetite
  • Cardiovascular collapse, death
  • Dilated pupils

Long-Term Effects:

  • Damage to brain cells containing serotonin
  • Over time, reduced level of dopamine resulting in Parkinson's-like symptoms
  • Weight loss
  • Confusion
  • Tremors
  • Convulsion
  • Paranoia
  • Hallucinations
  • Damage to nerve cells, causing strokes
  • Cardiovascular collapse, death

Effects from Withdrawal:

  • Irritability
  • Anxiety
  • Paranoia
  • Aggressiveness
  • Fatigue and long periods of sleep
  • Depression

Behaviors resulting from amphetamine intoxication such as withdrawal from others, experiencing hallucinations, paranoia, delirium perhaps occurring with violence and stereotyped behaviors such as repeatedly assembling and dissembling electronic equipment may resemble symptoms of schizophrenia. But a skilled clinician should be able to make the proper diagnosis.

ABOVE: Psychology Today's Diagnosis Dictionary: Amphetamines; last reviewed by Fiery Cushman on Jan. 10, 2005; captured from www.psychologytoday.com on Jan. 8, 2008.

“Amphetamine, as with cocaine, can induce symptoms similar to those seen in obsessive disorder, panic disorder, and phobic disorders.”

ABOVE: Kaplan and Sadock's Synopsis of Psychiatry (2007) citing American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

“High doses and long-term use of amphetamines are associated with erectile disorder and other sexual dysfunctions.”

ABOVE: Kaplan and Sadock's Synopsis of Psychiatry (2007) citing American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

Description

Although Lisdexamfetamine is referred to as “pro-drug” of dextroamphetamine, it is still an amphetamine, meaning that it is easily abused and can cause insomnia, agitation, anxiety and sometimes psychotic symptoms like seeing things or becoming paranoid. The difference between Lisdexamfetamine and Adderall is that Lisdexamfetamine will work only if it is swallowed so that drug abusers will not be able to snort or inject it. It is hoped this will limit abuse of Lisdexamfetamine.

A 30 mg Vyvanse capsule is molecularly equivalent to 8.88 mg dextroamphetamine.

Used For

  • Attention deficit disorder

How Amphetamines Work

When we are stressed or under threat, the central nervous system prepares us for physical action by creating particular physiological changes. Amphetamines prompt the brain to initiate this 'fight or flight' response. These changes include:

  • The release of adrenaline and other stress hormones
  • Increased heart rate and blood pressure
  • Redirected blood flow into the muscles and away from the gut

In small doses amphetamines can banish tiredness and make the user feel alert and refreshed. However, the burst of energy comes at a price. A "speed crash" always follows the high and may leave the person feeling nauseous, irritable, depressed and extremely exhausted.

Do Not Use If

You have not tried other psychotherapy, have high blood pressure or any form of heart disease, are very nervous or have severe insomnia, have a history of addiction to drugs or alcohol, or have Tourette syndrome. Do not combine with monoamine oxidase inhibitors.

Common Side Effects

  • Dry Mouth
  • Loss of appetite
  • Headache
  • Difficulty falling asleep (insomnia)
  • Nervousness including agitation, anxiety and irritability
  • Addiction

Less Common Side Effects

  • High blood pressure
  • Rapid pulse rate
  • Tolerance (constant need to raise the dose)
  • Feelings of suspicion and paranoia
  • Visual hallucinations (seeing things that are not there)
  • Depression
  • Cocaine craving
  • Dermatoses (infected or diseased skin)
  • Urinary tract infection
  • Infection or viral infection
  • Elevated ALT enzyme levels in the blood (signaling liver damage)

Overdose Side Effects

Amphetamines have been extensively abused. Extreme psychological dependence and severe social disability have resulted. Abuse of amphetamines may cause a sudden heart attack even in those with no signs of heart disease. Symptoms of overdose that require immediate medical assistance include:

  • Restlessness
  • Tremor
  • Aggression
  • Hallucinations
  • Panic states
  • Hyperreflexia (overactive reflexes, which can include twitching or spasms)
  • Personality changes
  • Symptoms of depression
  • Seizures or abnormal EEGs
  • High blood pressure
  • Rapid heart beat
  • Swelling of hands/feet/ankles (for example, numbing of the fingertips)
  • Delusions
  • Sweating
  • Vomiting
  • Dehydration
  • Unexplained muscle pain
  • Lower abdominal pain
  • Rhabdomyolysis and kidney damage
  • Chronic abuse can manifest itself as psychosis, often indistinguishable from schizophrenia

Amphetamine-Induced Anxiety Disorder

The onset of amphetamine-induced anxiety disorder can occur during amphetamine use or withdrawal, according to best-selling psychiatry text, Kaplan and Sadock's Synopsis of Psychiatry citing American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders.

"Amphetamine, as with cocaine, can induce symptoms similar to those seen in obsessive disorder, panic disorder, and phobic disorders," states Synopsis of Psychiatry.

Amphetamine-Induced Psychosis

Induction of schizophrenic-like states in children on prescribed doses of stimulant medications, including amphetamine prescription drugs, have been observed, according to The Journal of the American Board of Family Medicine.

Amphetamine-Induced Sexual Dysfunction

Referring again to American Psychiatric Association's Manual of Mental Disorders , Synopsis of Psychiatry states: "High doses and long-term use of amphetamines are associated with erectile disorder and other sexual dysfunctions."

Lisdexamfetamine is a Schedule II Substance, which means Lisdexamfetamine has a "high potential for abuse" that "may lead to severe psychological or physical dependence," and the federal government sets limits on the amount of these amphetamine drugs that may be manufactured each year.

ABOVE: 21 USC Sec. 812 01/22/02. Drug Enforcement Administration, US Department of Justice. www.dea.gov/pubs/csa/812.htm.

Dependence, Tolerance and Withdrawal

It is possible to build up a tolerance to amphetamines, which means the person using the drug needs to take larger doses to achieve the same effect. Over time, the body might come to depend on amphetamines just to function normally. The person craves the drug and their psychological dependence makes them panic if access is denied, even temporarily.

Withdrawal symptoms can include tiredness, panic attacks, crankiness, extreme hunger, depression and nightmares. Some people experience a pattern of "binge crash" characterized by using continuously for several days without sleep, followed by a period of heavy sleeping.

If It Doesn't Work

The drug should be stopped gradually. Withdrawal symptoms are psychological and stopping suddenly can cause extreme fatigue and severe, even suicidal, depression in adult patients.

Abrupt cessation of amphetamines such as Lisdexamfetamine can cause extreme fatigue and severe, even suicidal, depression in adult patients.

ABOVE: The Essential Guide to Psychiatric Drugs—Rev. and updated (2007).

If It Does Work

“In the treatment of ADHD for children and young adults, [amphetamine] is now prescribed frequently, often as a first-line drug. This is, in my opinion, a very serious mistake,” states Jack M. Gorman, M.D., professor of psychiatry at Columbia University and deputy director of the New York State Psychiatric Institute. Amphetamine “is now abused throughout college campuses, where it is bought, sold, stolen, borrowed, snorted and injected. It is a very powerful drug that undoubtedly works for ADHD, but there are alternatives with less abuse potential that should be tried first.”

If you have taken a newly released medication, you, too, are part of the great ongoing clinical trial. When a new drug is approved less than half of its serious reactions are known. The FDA relies upon you, the consumer, to determine the other half.

ABOVE: Cohen, J.S. Over Dose: The Case Against the Drug Companies: Prescription Drugs, Side Effects, and Your Health. New York: Penguin Putnam Inc., 2001.

New Medications: Are You a Drug Guinea Pig?

Drug companies have realized the enormous demand for psychiatric medications and are actively working on many new ones. When a manufacturer brings out a new drug, they advertise it aggressively. However, pre-marketing trials, performed to satisfy the FDA requirements for new drugs, test at most a few thousand people in a very structured environment.

The FDA considers the first years in the marketplace as Phase IV of a clinical trial because that's when the drug is really put to the test, treating a diverse cross-section of the population. [More]

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What is the most important information I should know about VYVANSE?

VYVANSE is a stimulant medicine. The following have been reported with use of stimulant medicines [AMPHETAMINES].

1. Heart-related problems:

  • sudden death in patients who have heart problems or heart defects
  • stroke and heart attack in adults
  • increased blood pressure and heart rate

Tell your doctor if you or your child have any heart problems, heart defects, high blood pressure, or a family history of these problems. Your doctor should check you or your child carefully for heart problems before starting VYVANSE.

Your doctor should check you or your child's blood pressure and heart rate regularly during treatment with VYVANSE.

Call your doctor right away if you or your child has any signs of heart problems such as chest pain, shortness of breath, or fainting while taking VYVANSE.

2. Mental (Psychiatric) problems:

All Patients

  • new or worse behavior and thought problems
  • new or worse bipolar illness
  • new or worse aggressive behavior or hostility

Children and Teenagers

  • new psychotic symptoms (such as hearing voices, believing things that are not true, are suspicious) or new manic symptoms

Tell your doctor about any mental problems you or your child have, or about a family history of suicide, bipolar illness, or depression.

Call your doctor right away if you or your child have any new or worsening mental symptoms or problems while taking VYVANSE, especially seeing or hearing things that are not real, believing things that are not real, or are suspicious.

What do Amphetamines Include?

BRAND NAME GENERIC NAME
Adderall amphetamine plus dextroamphetamine
[instant release]
Adderall XR amphetamine plus dextroamphetamine
[extended release]
Benzedrine amphetamine
[instant release]
Biphetamine amphetamine plus dextroamphetamine
Desoxyn methamphetamine
[instant release]
Dexedrine dextroamphetamine
[instant release]
Dexedrine SR dextroamphetamine
[extended release]
Dexedrine Spansule dextroamphetamine
[extended release]
Dextrostat dextroamphetamine
[instant release]
ProCentra dextroamphetamine
[immediate release, bubblegum flavor]
Vyvanse dextroamphetamine
with lysine (lisdexamfetamine)
[extended release]
  • ALTERNATE NAMES:
  • amphetamine = amfetamine = dl-amphetamine
  • dextroamphetamine = dexamfetamine
    = dexamphetamine = d-amphetamine
  • methamphetamine = d-methamphetamine

All amphetamines have essentially the same chemical properties and actions, states a 2005 published report by the Drug Enforcement Agency (DEA). Amphetamine, dextroamphetamine and methamphetamine are so alike, according to the DEA report, that even experienced users may not feel a difference between them.

ABOVE: Drug Enforcement Administration, US Department of Justice. “Amphetamines,” Drugs of Abuse Publication. National Drug Intelligence Center, 2005 ed. www.usdoj.gov/dea/pubs/abuse.

Amphetamines May Cause 60% Increase in Risk of Parkinson's Disease

Users of amphetamines, like Adderall, may be nearly 60 percent more likely to develop Parkinson's disease than those who don't take the drugs, suggests a 31-year study, presented at the American Academy of Neurology's 63rd Annual Meeting.

The study involved 66,348 volunteers in California. The average age at the start of the study was 36. By 1995, according to the researchers, 1,154 of the amphetamine-users had been diagnosed with Parkinson's disease.

The study's author stated: “If further studies confirm these findings, the potential risk of developing Parkinson's disease from these types of amphetamines would need to be considered by doctors before prescribing these drugs as well as be incorporated into amphetamine abuse programs, including illicit use.”

Amphetamines are now often prescribed to increase wakefulness and focus for people with attention deficit hyperactivity disorder, narcolepsy, and traumatic brain injuries. But when this study was conducted, between 1964 and 1973, amphetamines (Dexedrine and Benzedrine) were commonly used for weight-loss. Adderall is a blend of four amphetamines that includes Dexedrine and Benzedrine.

ABOVE: PR Newswire, “Using Amphetamines May Increase Risk of Parkinson's Disease,” St. Paul, Minn., 2/22/2011. (The study was supported by Kaiser Permanente Northern California.) www.prnewswire.com/news-releases/using-amphetamines-may-increase-risk-of-parkinsons-disease-116660444.html

What is Your Adderall IQ?

Amphetamine Advantage or Dangerous Delusion?

Like athletes who use steroids, students who use amphetamines to enhance academic performance are in many ways victims. [More]

High-Fructose Corn Syrup May Hurt Cognition and Memory

Los Angeles, CA -- A recent study from the University of California Los Angeles (UCLA) brings new evidence about how high-fructose corn syrup (HFCS) may effect the brain. Researchers measured HFCS influence on insulin signaling, synaptic platicity in the brain, and behavior. They concluded that HFCS consumption impaired cognitive ability and provided evidence of how HFCS may have more of an effect than previously known on cognition and memory.

How Safe is Ritalin?

Many think methylphenidate (Ritalin) is safe, or mild, because so many children use it. However, the government classifies the psychoactive drug with cocaine and morphine because it is highly addictive. [More]

Adderall XR Side Effects

In small doses amphetamines can banish tiredness and make the user feel alert and refreshed. However, the burst of energy comes at a price. A "speed crash" always follows the high and may leave the person feeling nauseous, irritable, depressed and extremely exhausted. [More]

Strattera Side Effects

Most people may not know that Strattera (atomoxetine) appears to cause unsatisfactory sexual function (decreased libido, ejaculatory problems and impotence). [More]

Focalin Side Effects and Warnings

Focalin is a chemical variant of methylphenidate, dextro- or dexmethylphenidate, and also comes in an XR version. Naturally, the manufacturer claims it is better than other versions of methylphenidate, but that claim is met with skepticism by many psychopharmacologists. [More]

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