Adderall vs Vyvanse - What's the difference between them?
The main difference between Adderall and Vyvanse is that Adderall is a mixture of four different kinds of amphetamine salts while Vyvanse only contains one type of amphetamine salt, called lisdexamfetamine.
Lisdexamfetamine gets converted into dexamphetamine once it is in the body. The four amphetamine salts that Adderall contains are dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate.
One advantage of Vyvanse is that it may be less likely to be abused; however, there are no head-to-head trials that compare the abuse potential of Vyvanse to Adderall. One disadvantage of Vyvanse is that there is no generic form available, which makes it more costly than Adderall.
Because both drugs contain amphetamines, they work in a similar way. Studies have shown that Vyvanse is just as effective as Adderall, and side effects are similar.
The risk of dependence (this means how likely you are to become dependent or addicted to the drug) appears similar for both Adderall and Vyvanse.
What is in Adderall and Vyvanse?
Adderall is a brand name for a combination drug that contains four different types of amphetamines (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate). It's easier to call these mixed amphetamine salts, or MAS for short.1
Vyvanse is the brand name for lisdexamfetamine. Once lisdexamfetamine is inside the body it gets converted into dextroamphetamine (its active form) as soon as it touches red blood cells.2
Because Adderall and Vyvanse both contain amphetamines they work in a similar way, and that is by blocking the re-uptake of two neurotransmitters (chemical substances that help nerves talk to each other) in the body. These neurotransmitters are called norepinephrine and dopamine. By blocking their re-uptake, levels of these neurotransmitters between nerves are increased, which helps relieve symptoms of inattention and agitation in children and adults with ADHD.1
Are there any studies that directly compare Adderall to Vyvanse?
Unfortunately, researchers have not really looked into how effective Adderall is compared to Vyvanse, and vice-versa. One study did look at the effect both drugs had on classroom-based behavior in a group of children with ADHD, and reported that both seemed equally effective at improving attention-span, rule following and interactions with peers and adults. Both were well tolerated and no significant differences were noted in their side effects.3,4
Similar results were reported in a trial of 18 adults with ADHD. It took about two hours for Adderall to start working and three hours for Vyvanse, and the effects of each drug lasted for approximately 16 hours. 5,6
Many other studies have compared Adderall or Vyvanse to placebo (an inactive pill) or to other medications used for ADHD and confirmed that both Adderall and Vyvanse improve various symptoms of ADHD.7,8,9,10,11 Researchers did not find one type of drug more effective than another and side effects such as decreased appetite, insomnia, and abdominal symptoms were common but similar among different preparations. However, it is worthwhile noting that most trials in people with ADHD last less than six months, are poorly reported and fail to include important social outcomes such as parent stress and quality of life.
Which drug is more likely to be abused?
Adderall has more potential to be abused, mainly because it contains free amphetamine salts. Lisdexamfetamine (the ingredient of Vyvanse) requires contact with red blood cells in the body to be activated into dextroamphetamine, which suggests it has inbuilt abuse-deterrent properties4. Unfortunately, no head-to-head trials comparing the abuse potential of Vyvanse to Adderall have been done.4,12
Lisdexamfetamine is still classified as a controlled substance with a high potential for abuse, and those people prescribed Vyvanse and Adderall should take care to store their medicines safely to avoid non-authorized use, as misuse of amphetamine-type medicines can cause sudden death, stroke, heart attack, convulsions and psychotic reactions.1,2,12
Which is cheaper? Adderall or Vyvanse?
Because Adderall is available in a generic form, it can be purchased for less than Vyvanse. Adderall XR 5mg costs approximately $753 per 100 capsules ($7.53 per capsule)13, and the generic version is available for $58.14 – $175.95 for 100 capsules (from 58 cents per capsule)14.
Lisdexamfetamine is only available as Vyvanse, at a cost of $1,175.24 for 100 capsules of any strength ($11.75 per capsule).15 Don't hold your breath for a generic - one isn't expected until 2023!16
Is Adderall better because it is available as an extended-release?
No. Although Adderall is available in both an immediate-release and extended-release form, an expert review failed to find any differences in effectiveness between immediate and extended-release dosage forms.10
Interestingly, Vyvanse actually "behaves" like an extended-release form once it is inside the body - because the contact with red blood cells and the cleaving off of dextroamphetamine takes time. 4
- Adderall (dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate) [package insert]. Revised 04/2020 Teva Pharmaceuticals USA, Inc. https://www.drugs.com/pro/adderall.html
- Vyvanse (lisdexamfetamine) [package insert]. Revised 10/2019 Shire LLC https://www.drugs.com/pro/vyvanse.html
- Biederman J, Boellner S, Childress A, et al. Improvements in Symptoms of Attention- Deficit/HyperactivityDisorder in School-aged Children With Lisdexamfetamine (NRP104) and Mixed Amphetamine Salts, Extended-Release Versus Placebo. https://www.biologicalpsychiatryjournal.com/article/S0006-3223(07)00363-0/abstract
- Allen SN. Adderall XR® and Vyvanse™. New" psychotropics: New chemical entities and new dosage forms. Mental Health Clinician 2014;4(1):8-10. https://meridian.allenpress.com/mhc/article/4/1/8/37052/Adderall-XRR-and-Vyvanse
- Martin PT, Corcoran M, Zhang P, Katic A. Randomized, Double-Blind, Placebo-Controlled, Crossover Study of the Effects of Lisdexamfetamine Dimesylate and Mixed Amphetamine Salts on Cognition Throughout the Day in Adults with Attention-Deficit/Hyperactivity Disorder. Clinical Drug Investigation. 2014;34(2):147-57. doi:10.1007/s40261-013- 0156-z.
- Faraone S V, Biederman J. Efficacy of Adderall for attention-deficit/hyperactivity disorder: a meta-analysis. Journal of Attention Disorders.2002;6(2):69-75
- Maneeton N, Maneeton B, Suttajit S et al. Exploratory meta-analysis on lisdexamfetamine versus placebo in adult ADHD. Drug Des Devel Ther. 2014; 8: 1685–93 doi: 10.2147/DDDT.S68393 PMCID: PMC4199984 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199984/
- Isquith PK, Roth RM, Gioia GA, and PAR Staff. Behavior Rating Inventory of Executive Function -Adult Version™ BRIEF-A™. Interpretive Report. http://www4.parinc.com/WebUploads/samplerpts/BRIEFA_InformantInterp.pdf
- Wigal SB, Raja P, Shukla A. An update on lisdexamfetamine dimesylate for the treatment of attention deficit hyperactivity disorder. Expert Opin Pharmacother. 2013 Jan;14(1):137-45. doi: 10.1517/14656566.2013.754013. http://www.tandfonline.com/doi/abs/10.1517/14656566.2013.754013?journalCode=ieop20
- Castells X, Ramos-Quiroga JA, Bosch R, et al. Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults. Cochrane Database of Systematic Reviews 2011, Issue 6. Art. No.: CD007813. DOI: 10.1002/14651858.CD007813.pub2. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007813.pub2/full
- Punja S, Shamseer L, Hartling L, et al. Amphetamines for attention deficit hyperactivity disorder (ADHD) in children and adolescents. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD009996. DOI: 10.1002/14651858.CD009996.pub2. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009996.pub2/full
- Simon K, Worthy SL, Barnes MC, Tarbell B. Abuse-deterrent formulations: transitioning the pharmaceutical market to improve public health and safety. Therapeutic Advances in Drug Safety. 2015;6(2):67-79. doi:10.1177/2042098615569726. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406920/
- Adderall XR Prices, Coupons and Patient Assistance Programs Drugs.com https://www.drugs.com/price-guide/adderall-xr Accessed 01/2021
- Amphetamine/dextroamphetamine Prices, Coupons and Patient Assistance Programs. Drugs.com https://www.drugs.com/price-guide/amphetamine-dextroamphetamine Accessed 01/2021
- Vyvanse Prices, Coupons and Patient Assistance Programs. Drugs.com https://www.drugs.com/price-guide/vyvanse Accessed 01/2021
- Generic Vyvanse Availability Drugs.com. https://www.drugs.com/availability/generic-vyvanse.html Accessed 01/2021
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