Treating ADHD: Vyvanse Versus Concerta XR

In 2007, the FDA approved Vyvanse in the management of Attention Deficit Hyperactivity Disorder, ADHD, in children. For many children, this approval marks the change from one classification of stimulant to another classification of stimulant, often producing a completely different set of reactions and side effects.

As the parent of a teenager who suffers from ADHD, I can personally attest to the side effects of Vyvanse, an amphetamine based stimulant, to the side effects of non-amphetamine based stimulants, such as Concerta XR.

As an adolescent with ADHD, and like most adolescents with ADHD, it is vitally important to manage the ADHD symptoms with both medication and therapy. For adolescents, learning to manage ADHD, through therapy, is important to making the transition into adulthood. To achieve the optimal results of therapy, and to promote social and academic performance, however, many adolescents need to be manage with medications first.

My son was first one Concerta XR. As a non-amphetamine based stimulant, Concerta XR was provided in the maximum dose of 54 milligrams per day, administered once-per-day with breakfast. With Concerta XR, my son’s ADHD symptoms would be well controlled within 30 minutes of use and continue to provide that degree of control for approximately 10 hours; enough to make it through the school day.

Unfortunately, as evening approached, and the Concerta XR began to wear off, my son’s personality would experience extreme flat affect, known as the “rebound effect”, followed by a restoration of the ADHD symptoms. This restoration of the ADHD symptoms, at dinnertime and into bedtime has made it quite difficult to focus on homework, household chores and preparing for the next day.

As with most adolescents, my son complained of the side effects with Concerta XR. Reporting he felt as if his emotions were subdued, impairing his social interaction, and losing extreme desires to eat or do anything other than to “zone out”. This subdued effect of Concerta XR was definitely evident even within 30 minutes of dosing the medications.

As a teenager with ADHD, the psychiatrist has opted to transist to the new amphetamine based stimulant known as Vyvanse. While the drug is habit forming, it is believed to be a better option in treating teenagers with ADHD as it should not affect social affect or mood.

At the lowest dose of Vyvanse, 30 milligrams, my son was administered this once-per-day dose also at breakfast. While the results were not immediately realized as with Concerta, within two hours the effects of Vyvanse were evident by my son’s ability to focus in his first class at school.

However, by lunch time, four to five hours after dosing, the blood pressure had risen to 150/110, he was incoherent and he seemed very agitated. Unsure why this effect occurred, the psychiatrist has opted for a titrated dosing schedule to slowly accustom my son to the new Vyvanse treatment for ADHD.

As the parent of a teen with ADHD, you probably know, firsthand, the importance of medication management and therapy. For many teens, ADHD not only results in the all-too-familiar complications of inattention and lack of focus, but may also produce additional complications involving impulsivity and aggression. To control these symptoms, many families are turning to medication management only to find the side effects are varied and complicated.

If your child is experiencing unusual side effects with the use of ADHD prescription medications, ask your physician to offer information on the possible change in drug class. While each drug class results in differing side effects, ultimately you will find one prescription drug that will work best for your ADHD teenager.