Tuesday, November 6, 2007

New ADHD Medicine

Vyvanse is a new form of Adderall that may have advantages for some patients. The advantages may be a more consistent improvement in ADHD symptoms throughout the day and may last longer than the extended release Adderall. There may be less abuse potential as well.

Vyvanse is a prodrug. A prodrug is not an active medication until it is metabolized in the body. Vyvanse is a compound of a protein and amphetamine. In the body amphetamine is split off from the protein and becomes active and goes to the brain. This splitting off is a chemical reaction that is rate limited. Therefore the amphetamine is released at a consistent, controlled rate that prevents spikes and dips of brain amphetamine concentrations throughout the day. When there is a spike, side effects of jitteriness, tremor, or edginess occur. When there is a dip, focus and productivity decrease. The brain level of the medication falls only after all the Vyvanse has been metabolized. The duration of the benefits lasts for 12 hours or longer if the dose given is high enough for the patient.

The risk of abuse is reduced because the amphetamine is bound to the protein. It is very difficult for drug abusing individuals to free the amphetamine and get it into the bloodstream by snorting or injecting it.

The FDA approved Vyvanse this summer for the indication of ADHD based on studies done in children and adolescents. We expect it to be effective and safe for adults with ADHD as well.

Vyvanse comes in 30, 50, and 70 mg dosages. We expect patients to benefit most and tolerate it best if their dosage of Vyvanse approximates 2-2.5 times their current total daily dosage of extended release and/or immediate release Adderall, especially for patients who have been taking multiple doses per day to have at least 12 hours of therapeutic blood levels per day.

If you are not already one of our patients, please call for an appointment to be evaluated so we can discuss these potential benefits for you.

Darvin Hege, M.D.

For more information about Vyvanse:
http://eveningpsychiatrist.blogspot.com/2008/01/vyvanse-update-on-first-100-patients.html and

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