Vyvanse: How it works_Adult ADHD medication treatment specialist psychiatrist Dr. in Atlanta on the new Adderall named Vyvanse.

VYVANSE_HOW IT WORKS

Adult ADHD medication treatment specialist psychiatrist doctor in Atlanta on the new Adderall named Vyvanse.

Vyvanse has several advantages over Adderall XR, Adderall, dexedrine and other amphetamine preparations. It provides more consistent concentration assistance throughout the day, lasts longer, i.e., from morning till bedtime, all in a convenient, single morning dose, and less likely to reach abusive or overdose brain levels because of an enzyme regulatory action.

Here’s how it works. In the lab they took the dextroamphetamine molecule and stuck it onto a protein molecule. You swallow the capsule with the compound inside and it is absorbed from your intestine into your bloodstream and goes to your brain. However, the amphetamine molecule can’t get into your brain cells to help your concentration because the protein molecule is too big to get through the door into your brain cells. Enzymes in the body cleave the amphetamine from the protein. I use the following analogy to help my patients understand. The situation is like a waiting line outside a nightclub. The Vyvanse compounds of dextroamphetamine and attached protein molecules are like people with large backpacks that are too big for the small doors into the club. The people need the assistance of the bouncers at the door to help remove their backpacks and grant permission to enter the club. The bouncers activity is similar to the enzyme’s action. They allow the patrons to enter at a regulated rate. The longer the line of patrons, or Vyvanse, the later in the day the last amphetamine enters the brain cells. There is a limited number of these enzymes in your body so they put a ceiling on the rate of entry and the concentration level of amphetamine in your brain cells. Hence, you are less likely to overdose or abuse the amphetamine to get high concentrations of amphetamine into your brain. This also prevents spikes of high concentrations that cause jitteriness, edginess, nervousness,or anxiety that are often experienced in the early minutes or hours after taking the immediate release form or the extended release Adderall. Now this steady action of these enzymes on the Vyvanse compound also provides protection from the dips in concentration that are experienced with the other amphetamine preparations.

The longer duration action of Vyvanse is also related to this rate limited enzyme action. If we raise the dose of Vyvanse, we lengthen the waiting line of Vyvanse-protein molecules waiting to be cleaved to enter the brain. We can adjust up the dose so that you can have consistent focus from morning to bedtime. We adjust the one time morning dose of Vyvanse in this fashion. Pull the capsule apart and dump the ingredients into a measuring cup of water. Stir the solution and the Vyvanse compound dissolves in the water. Remember that the protein is only cleaved from the amphetamine by enzymes inside the body. After you have calculated the duration of hours that a particular dose of Vyvanse lasts, you drink the amount of solution proportionate to the number of hours you want the Vyvanse concentration to last. If you want it to last longer than your capsule dose, you swallow your capsule plus the measured solution. If you are going to have a short day or forget to take your Vyvanse until later in the day, you just take the proportionate fraction of your dose in solution form. If you find out later in the day one day that you’re going to need to concentrate longer that day than what you had dosed for that morning, you can take an additional partial fraction of a capsule dose at that time. You may then save the remaining aliquot of solution in the refrigerator for ingestion the next day.

Pharmacist s often are not aware yet that you may take partial doses, but you can tell them that “It’s in the package insert”. Now they may tell you that you can’t save the balance of the solution for the next day. That is what the package insert says because it was not researched in the clinical trials. However, my colleagues and my patients rarely report any loss of benefit or other effects.

For more blogs by Dr. Hege about Vyvanse

http://eveningpsychiatrist.blogspot.com/2008/01/vyvanse-update-on-first-100-patients.html
http://eveningpsychiatrist.blogspot.com/2007/11/new-adhd-medicine.html


Darvin Hege, M.D.
February 4, 2008