Vyvanse for ADHD in Children

Vyvanse is an amazing ADHD medication but it has a few problems when used for ADHD in children.  This relatively new ADHD drug provides continuous stimulant coverage in a very smooth fashion.  The drug consists of dextroamphetamine bonded to the amino acid lysine.  The dextroamphetamine is only absorbed when the lysine bond is broken and this can only happen in the stomach or small intestine.  This provides for an amazingly smooth delivery of the dextroamphetamine into the blood stream. This delivery system has the added effect of making this ADHD drug impossible to abuse as you will get no effect if you crush it, inject it or snort it.

Vyvanse's effect is very long acting, between 10-14 hours and there are some physicians who believe that the stimulant effect of Vyvanse is stronger than the stimulant effect of other dextroamphetamines such as Adderall.

 My 8 year old son has been on Vyvanse for about 6 months and has done well on this ADHD medication except for two problems that are both related to the duration of action.  The first problem is that he is not very hungry for 13 hours, which is the amount of time the drug action last for him.   At dinner time, which for us is at 6pm, he usually will only eat about half his dinner.  Families that have children with ADHD make all kinds of adjustments to family schedules and routines to accommodate problems such as this one.  What we have done is set aside his dinner plate until it is time for his bedtime snack.  By that time he is hungry and he then eats the rest of his dinner.

The second problem is that my son has days when he does not need, nor do we want him to have a 13 hour stimulant effect.  There are weekend days when he sleeps in until 11 am.  He has always been a good sleeper and when he wakes up at 11am it is likely that he will still go to sleep at his regular bedtime of 9pm.  On those days, we cannot give him his Vyvanse because if we do he will be awake until 1 in the morning.  There is no way to shorten the duration of action of Vyvanse.  Giving him half the dose just halves the stimulant effect, not the duration of action.

We saw the Psychiatrist yesterday.  I told him that he was doing great on the ADHD medication except for the weekend issue.  The psychiatrist suggested that I set my alarm for 7am on weekends and wake him up and give him his medication.  A ridiculous suggestion such as this one is why physicians get the terrible reputation that they sometimes get.  Had I not been a health care provider who felt comfortable 'talking back to a physician', I might have not had the audacity to tell this man that he was absolutely out of his mind if he thought that any parent, in their right mind, was going to wake their sleeping ADHD child to give them a stimulant at 7am on a peaceful weekend morning.   

The psychiatrist admitted that this was perhaps not a great idea and he asked me what I would suggest.  I told him that what my son needed was an 8 hour duration ADHD medication for those 'short days' when he slept in  late.  My son now has a prescription for Adderall XR for those days when he does not need 13 hours of coverage. 

I seriously doubt that I am the only parent of a young child with this problem.  My guess is that the drug manufacturer will come out, some day, with a children's monthly dose pack of Vyvanse that includes two to four days of a shorter acting dextroamphetamine for the occasional days in the month that the child does not need 12-14 hour coverage.   If this does not happen, I hope that psychiatrist will ask parents what they are doing on 'short days' when their children sleep in late.  Children with ADHD should not be off their medication simply because they woke up late and parents should not be having to wake up their slumbering children to give them ADHD medication.

1 comment:

  1. I am a 20 year old college student with primarily inattentive ADHD. I was diagnosed 7 months ago and began a Vyvanse regiment. I saw immediate (and WONDERFUL!) improvements in the many areas in my life affected by ADHD after starting on Vyvanse.

    I also experienced the same reduced hunger. In order to handle this I usually try to eat a larger breakfast during which I take my medication. By eating just before or right after I take my daily dosage I can get a good meal in before the Vyvanse takes effect and begins suppressing my apetite for the duration of the day.

    Another method to try is to keep small snacks like grapes or nuts at hand to munch on. This seems to help because since I don't desire a full lunch while on my meds, smaller and more spaced out amounts of food are easier and feel more natural to take during the day.


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