Talk:Lisdexamfetamine/Archive 1

Archive 1

Duration of action evidence

Tere is debate below and discussion in the article on duration of action (and why it lasts 12-14 hours). I think the below two articles would be useful and should be incorperated, but I lack experience in editing wikipedia to do it myself.

First article-Note in particular 'counterclockwise hysterisis' or some such, that causes vyvanse to keep working even after reaching peak plasma concentration (as opposed to dexedrine, which would reach max effect at peak plasma)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666194/#!po=30.8511

Second article-Study demonstrating 13 hour effect for inattention and problem solving benefits (though some hyperactivity benefits start to poop out around hour 10) (note also that placebo group experienced some decline in performance as day went on - some things people interpret as drug wearing ofd may just be a natural decline pver the day) (also note that vyvanse treated group started day worse off than placebo - some residual 'coming down' from previous day's dose is experienced in morning, but relative to placebo vyvanse treated subjects improved on all measures out to hour 13, much more than making up for this initial gap).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704174/ — Preceding unsigned comment added by 65.96.172.165 (talk) 18:08, 29 September 2013 (UTC)

Misuse potential

i never edit wikipedia but this really needs to be edited if you want correct info it defintly can be "abused"(if making yourself euphoric is considered abuse) and causes obvious euphoria in dosages as low as 30 and consistently for me and many others at the prescribed dose 50,60 or 70 or more, often considered by people to be similar to a light ecstasy roll. "and taking longer to metabolise than dextro-amphetamine (both results of being a pro-drug (causes it to be less abusable)" but what this also means is that when it does metabolize the abuse lasts longer in duration. therefore this drug is quite abusable orally, with this common misconception it is easier to obtain as those prescribing it believe it to not be abusive, when in fact its often sold at colleges —Preceding unsigned comment added by 76.185.10.163 (talk) 01:07, 12 January 2011 (UTC)

Common heart problem

I think it's worth mentioning issues about fast heart rate somewhere, it's apparently a common occurrence, from what I've seen in the Vyvanse section of addforums.com. I had this problem and I didn't know what to do, I couldn't think because I was trying hard to concentrate on breathing right. I was starting out on Vyvanse, and I was looking in this article at the side-effects (so that I can monitor them and record information for my docs and therapist), I mostly was looking in the common side effects, I only occasionally looked at the severe side effects, since "Very infrequent but possibly severe side effects requiring immediate medical attention may be caused by lisdexamfetamine; these serious reactions include:" lead me to believe that those side effects were very rare. When the issue started up for me, my heart rate was fast enough for me to be able to feel it, and I remembered this line "Many individuals taking lisdexamfetamine will experience side effects, but for the majority the severity of the side effects is not severe. Lisdexamfetamine, like other amphetamines, can cause severe and possibly life-threatening side effects and even sudden death in sensitive individuals.", which caused me to panic. The combination of those two lines insinuates that what I'm experiencing is very rare, and knowing that heart disease is the leading cause of death in the U.S, these sets of information are enough to cause panic, which in a situation of increased bpm is not at all helpful. Fortunately I calmed down when I found on addforum.com that it is a common issue that many users (at least on that website, not sure about the rest) faced by many in the beginning of usage.

Since a great deal of people my age(teens, especially high schoolers) use this website for most information, especially when Google fails to produce answers (which it did at first for me), I really feel that for safety reasons it should be mentioned somewhere in the side effects about the heart issues. I'm not going to add it, since I'm really too tired, but someone definitely should look around the Vyvanse section of addforum.com for sufficient information to add on, which shouldn't be hard, there's usually many questions about it on the first page.

I know that an increased heart rate qualifies as Tachycardia, but the article on it, if I can remember correctly, states 120 bpm at rest, when people are generally experiencing 90-110 bpm. This is just a common side effect that I felt should be brought to Wikipedia's attention. (Just FYI, it still is something the doctor needs to be informed about.) —Preceding unsigned comment added by 173.74.134.223 (talk) 02:55, 24 July 2010 (UTC)

PI? Interactions? Really?

Do we really need to call out the entire prescribing information for Vvyanse and every single, individual interaction it has? Seems excessive and unnecessary. All other pharms on Wikipedia don't have every single interaction indexed on the page. Clutter versus useful data is a bad ratio on this one.

I vote to remove the entire Interactions section and only leave the relevant, highly useful interactions that would impact the majority of the population, only.

—Preceding unsigned comment added by 204.111.154.29 (talk) 15:21, 31 March 2010 (UTC)

I already made a point to bring this up on the bottom of the discussion page and no one has really done anything. But I wholeheartedly agree with you, there is no need for every possible interaction to be listed especially in format it is currently. This is why people have doctors. I'm going to go ahead and just remove it. Plus there is the dextroamphetamine entry that is more comprehensive in the first place. -Novaprospekt (talk) 21:07, 8 April 2010 (UTC)

"This is why people have doctors." Please do not assume the doctor will take any time covering interactions. If you're lucky, you'll remember to ask them about side effects and then they may give you the information, but rarely (if ever), will you get this kind of information unsolicited. "I vote to remove the entire Interactions section." This kind of information is exactly why I am here. Fiona Marissa 16:47, 1 July 2010 (UTC) —Preceding unsigned comment added by Fionaussie (talk • contribs)

Untitled

76.90.53.237

Vyvanse (Lisdeamphetamine) is known to have a much "smoother" onset and comedown than adderall and adderall xr, with a much longer effective dosage span ranging up to 12 hours. It is also thought to be less easy to abuse than adderall, ritalin, and dexedrine because it cannot effectively be snorted or used intravenously. It may only be ingested orally, as the lisene molecule is naturally stripped away by our digestive system, releasing the drug subsequently. Users may still abuse the drug by swallowing a higher dose than prescribed. —Preceding unsigned comment added by 76.90.53.237 (talk) 08:56, 16 October 2007 (UTC)

Lysdexic?

Why does the name of this drug make me think of "lysdexic amphetamine"? --Damian Yerrick (talk | stalk) 02:11, 20 February 2008 (UTC)

a question

Hmm im pretty sure that this quote "A 25 mg Vyvanse capsule would be molecularly equivalent to a 10 mg Dexedrine Spansule (both the aforementioned pharmaceuticals are about 7.425 mg dextroamphetamine)" is wrong. When medication dosage is said to be 10mg. It's usually 10mg. Regardless of the binder that comes with the xr. Can someone help prove me wrong? —Preceding unsigned comment added by FacistSpotter (talk • contribs) 20:19, 4 February 2009 (UTC)

I dont know, but it could be they include the counterion in the salt in the dosage measurement. Since amphetamines are usually given as the salt, this would add weight to the molecule. —Preceding unsigned comment added by 74.244.126.207 (talk) 01:14, 16 August 2009 (UTC)

Lisdexamfetamine dimesylate is a salt. Mesylate is a salt or ester of methanesulfonic acid. SmarterThanILook (talk) 02:58, 7 March 2012 (UTC)

Bipolar depression... really?

I see someone has added that that Shire is going to apply to use this to treat bipolar, but bipolar is one of the things that usually ends up mentioned in a list of possible contraindications rather than treatable illnesses, so I am curious what the source is for this primarily because I'd really like to see if Shire has indeed addressed with this medication some of the shortcomings Dexedrine had when attempts were made in the distant past ("Why is this woman tired" ad campaign, etc) to use it for similar purposes. Zaphraud (talk) 04:17, 24 March 2008 (UTC)

Clarification There is no evidence that Shire has ever tried to apply Vyvanse to treat bipolar disorder —Preceding unsigned comment added by Slg278 (talk • contribs) 17:14, 4 May 2008 (UTC)

Look up the prescribing guides - Bipolar is a contradiction on every amphetamine-based medication. Amide10806 (talk) 09:01, 10 November 2008 (UTC)

Actually, it IS being prescribed at this time to treat major depression in those diagnosed with bipolar. I have personally seen it (being a mental health professional). I did read about it from a good source too, however, at this time I can't remember where that was - if I find it again, I will post it. SmarterThanILook (talk) 16:30, 7 March 2012 (UTC)

Ages 13 to 17?

From the article: "Vyvanse is FDA approved for the treatment of attention-deficit hyperactivity disorder in pediatric patients ages 6–12, and in adults." I don't think that's entirely clear. Does this mean it isn't approved for ages 13 through 17? --Damian Yerrick (talk | stalk) 16:46, 28 June 2008 (UTC)

Some teenagers are as large as (or larger than) adults. On the other hand, most teenagers are far more naturally insane than either younger children or adults, so perhaps it is not?? Zaphraud (talk) 01:46, 7 February 2011 (UTC)

Citations

I'm not sure if this constitutes a reliable source, but I have a citation for Shire wanting to replace Adderall with Vyvanse here http://www.mmm-online.com/SAMPLE-DOSSIER-Vyvanse/article/99178/

Citation for their aspirations/expectations concerning the market share here http://findarticles.com/p/articles/mi_m4PRN/is_2008_Sept_29/ai_n29464854

"Shire is confident in its ability to make VYVANSE the leading treatment in the ADHD market and, as Shire has demonstrated historically, to transition successfully the majority of patients from its current market leading product (ADDERALL XR) to the next generation prodrug ADHD product (VYVANSE)" "Shire plans to file VYVANSE for European approvals for pediatric indication in 2009" from http://www.prnewswire.co.uk/cgi/news/release?id=191236 which claims "Distributed by PR Newswire on behalf of Shire plc"

Amide10806 (talk) 09:10, 10 November 2008 (UTC)

abuse potential

i've heard that this drug is also used because it needs first pass metabolism first, thus reducing the likelihood that the drug will be snorted. can anyone confirm this? —Preceding unsigned comment added by Mkayatta (talk • contribs) 21:30, 20 July 2009 (UTC)

The drug cannot be snorted (also I bring question to the claim that intravenous lisdexamfetamine produced effects in the article) because it needs to be converted to dextroamphetamine by first pass metabolism.

TL;DR, yes it cannot be snorted, not that it isn't abusable, amphetamines are abusable no matter what route. C6541 (T↔C) at 20:38, 4 August 2009 (UTC)

"In animal studies, lisdexamfetamine produced behavioral effects qualitatively similar to those of the CNS stimulant dextroamphetamine. In monkeys trained to self-administer cocaine, intravenous lisdexamfetamine maintained self-administration at a rate that was statistically less than that for cocaine, but greater than that of placebo.[citation needed]" ~ "Intravenous administration of 50 mg lisdexamfetamine to individuals with a history of drug abuse produced positive subjective responses on scales measuring "Drug Liking", "Euphoria", "Amphetamine Effects", and "Benzedrine Effects" that were greater than placebo but less than those produced by an equivalent dose (20 mg) of intravenous d-amphetamine.[citation needed]"

A) I'd really like a citation for this and B) this made me laugh. So what we learned from the first quote is that amphetamine and its derivatives is less addicting to cocaine and that monkeys while loving their speed, love their cocaine more. I know that by self administer they mean the monkey pushes a button to get high, but I get images of monkeys with tourniquets shooting up and then cleaning their tree non-stop. Does anyone know what they do with the cocaine addicted monkeys afterwards? I really hope they aren't euthanized... With the second quote about the past drug abusers rating the drug I'd like to know what is meant by intravenous. i thought the entire point of this drug was so it couldn't be snorted or injected. If anyone could find a source for that study I'd really like to go over it and look at how they conducted the study. The way this is worded on the page makes it sound really shady. I say we delete or alter the second quote, and if a source isn't found in a week delete it. Anyone with me? —Preceding unsigned comment added by 129.186.252.144 (talk) 16:37, 19 October 2009 (UTC)

The "abuse potential" study comes directly from the prescription information packet (By Shire). It is a legitimate study though I see the section was replaced by a similar section that appears to stress the safety mechanisms of Lisdexamfetamine rather than the actual "misuse potential." And the claim that oral (or other routes) of administration have no "recreational value" is ridiculous. The aforementioned monkey-cocaine-amp study (printed by Shire!) directly contradicts this. Even if the article made a note that there is no recreational value at "prescribed doses," it is well known amphetamine-like stimulants have initial euphoria for some patients even if they truly have ADHD (and, of course, there's no white/black line as to what neurochemical composition constitutes "ADHD").

Intravenous means just that--lisdexamfetamine effects are sustained with this route of administration. As for the whole point of the drug being that it would not be snorted or injected: I'd like to think the reason was more monetary in nature. —Preceding unsigned comment added by 76.125.14.205 (talk) 06:49, 27 January 2010 (UTC)

spelling

why is it spelled with an "f" and not with "ph", like amphetamine usually is? —Preceding unsigned comment added by 88.117.81.225 (talk) 17:58, 8 October 2009 (UTC)

To make it so parents do not associate (which it should be, as it is an amphetamine) with street amphetamines, at least in my opinion. C6541 (T↔C) 03:50, 13 December 2009 (UTC)

Not exactly..."Amfetamine" is simply an older way of spelling the word that still means the same thing as the 'ph' spelling. It's kind of like how the British spell 'color' as 'colour' or 'hemoglobin' as 'haemoglobin'. They are the same thing. Also, when drug companies develop a new compound, they give it a suitable name that usually but not always hints at its actual identity. The word 'lisdexamfetamine' implies lysine dextro-amphetamine but the real way of writing it should be N-[(1S)-1-methyl-2-phenylethyl]-L-lysinamide (official IUPAC name) or simply L-lysine-D-amphetamine, as it is spelled 'lysine' not 'lisine.' -Novaprospekt (talk) 19:16, 29 May 2010 (UTC)

I noticed both the "f" and "ph" spellings, which has left me confused. Laurence R. Hunt, Kenora, Canada (talk) 02:54, 20 June 2011 (UTC)

"Amfetamine" is also the spelling according to WHO nomenclature. -Destruktor5000 (talk) 14:55, 4 November 2013 (UTC)

Lisdexamfetamine administered intravenously

http://jop.sagepub.com/cgi/content/abstract/0269881108093841v1, this study showed that intravenously administered lisdexamfetamine did not differ significantly from placebo. C6541 (T↔C) 03:40, 13 December 2009 (UTC)

Citation request for duration.

The article states "Vyvanse pills are available in dosages of up to 70 mg (for 12 Hours)."

However, I have seen no such number in the Vyvanse monograph or prescribing or medication guides. http://www.vyvanse.com/ —Preceding unsigned comment added by Exitao (talk • contribs) 09:14, 23 December 2009 (UTC)

Vyvanse is a prodrug called lisdexamfetamine which is basically a dextroamphetamine moiety conjugated to the amino acid lysine by an amino bond and that amino bond is easily cleaved when taken orally in vivo. It's half-life is documented to be 1-2 hours (average 1.5). The active component of Vyvanse that gives it its therapeutic effects is dextroamphetamine, once activated by the body. The half-life of d-amphetamine is well-documented but is also highly variable because the pH of your urine determines how fast it is cleared -- acidic urine shortens the half-life, alkaline urine lengthens it. Therefore a wide range is documented for d-amp but it is generally agreed that the average half-life is approximately 12 hours and that is usually what is cited for studies and information. -Novaprospekt (talk) 19:10, 29 May 2010 (UTC)

Clean-up the Interactions section

This section is poorly formatted/written and could really use a cleanup. I will add the tag to it, and maybe even do it myself if I can learn more about this drug. -Novaprospekt (talk) 04:06, 18 March 2010 (UTC)

I was a little tweaked out on this drug when I wrote that, so it probably does need clean-up. What exactly are you thinking? Reducing the amount of subsections? C6541 (T↔C) 04:41, 18 March 2010 (UTC)

Yeah the sub-sections need to be condensed and cleaned up -- consolidation is the word I'm looking for. I'd actually recommend including explicitly the amphetamine-class drug interactions instead of directing viewers to another page. For a drug as prevalent as Vyvanse (lisdexamfetamine) I think it deserves to be on this page. -Novaprospekt (talk) 02:00, 19 March 2010 (UTC)

Wait, sorry I am a bit confused, but where in the interaction section is the viewer being directed to another page? C6541 (T↔C) 03:33, 19 March 2010 (UTC)

Nevermind regarding the redirection, that's in the next section. Just the headers and format is messed up in interactions. -Novaprospekt (talk) 04:50, 19 March 2010 (UTC)

As stated at the top of the discussion page, I went ahead and removed the interactions section since it really doesn't warrant being in an encyclopedia article, especially considering its parent drug, dextroamphetamine doesn't even list them either. The main article is much less cluttered and easier to read now. If there are any objections please let me know but for now, it's gone. -Novaprospekt (talk) 21:11, 8 April 2010 (UTC)

Equivalent doses of Dexedrine and Vyvanse

I'm trying to work out the equivalent doses of Dexedrine for instant release (dexamphetamine sulfate) and Vyvanse (lisdexamfetamine mesylate). This article suggests (but does not explicitly state) a ratio of 2:5 (0.400), but the article dexamphetamine states that the ration is 0.2948. So which is it? Is the discrepancy an error in one of the articles, or is it related to the differing bioavailabilities? (i.e. on a strict molecular basis one ratio is correct, but on the basis of dosage-to-blood-levels the other ratio is correct) --Ginkgo100^talk 16:44, 4 September 2010 (UTC)

Intention to fully complete page

Lisdexamfetamine is a CII stimulant medication, relatively new to the pharmaceutical market. Current and new consumers of this medication will rely on Wikipedia for information, which is way the writer intents on completing this page with-in 30 days. The writer ask that every user with time and knowledge of lisdexamfetamine help complete this page, so the world can discover and understand more. --Cwilli49 (talk) 10:24, 12 September 2010 (UTC)

"It is the mark of an educated man to look for precision in each class of things just so far as the nature of the subject admits". - Aristotle

"Difficult to Abuse" Because it Loses Effect Intravenously: What About Orally?!!

What kind of double-talk is that? Doesn't that imply that it can be abused orally?

98.245.148.9 (talk) 12:28, 25 December 2010 (UTC)

Alert: There is a High Chance this Article Could Be a Target for "Corporate Spinning"

Think about it.

98.245.148.9 (talk) 12:31, 25 December 2010 (UTC)

IUPAC name corrected

The IUPAC name has been corrected, as the preceding name was incorrect for this compound.Jb88gogg (talk) 05:35, 7 March 2011 (UTC)

The IUPAC name that was present when I viewed this article was not the systematic nor the preferred name, but rather the IUPAC CAS-Like name. I have edited the article to reflect the correct information and added the previous name to synonyms. saumaun (talk) 16:31, 8 June 2012 (UTC)

Metabolism & Abuse Inaccuracies

In doing research on lisdexamfetamine, I discovered some inconsistencies between the results of scientific studies of the drugs and how the information was presented on the page. Specifically, I noted that the article claimed that metabolism into lysine and dextroamphetamine occurred in the gastrointestinal tract (while the article cited indicated that this happened in the red blood cells) and that lisdexamfetamine had no effect unless administered orally (while the article cited was discussing the effects of administration on likability and abuse). Admittedly, I am no professional and am therefore liable to misunderstanding of these scholarly articles, so please correct me if my changes to the page were inaccurate. — Preceding unsigned comment added by Atomshroom (talk • contribs) 19:43, 14 October 2011 (UTC)

Misuse section update possibility

Since this article has been written, much discussion on illicit drug use websites has occurred in regard to synthesis (or techniques) to D-amphetamine, increasing misuse potential dramatically. A very easy route from Lisdexamfetamine to D-amphetamine with easily obtainable materials (digestive enzymes: trypsin, specifically) has been released publicly. This being said, Lisdexamfetamine can easily be modified to D-amphetamine, then taken via snorting, IV, oral, or anal.

Essentially, the cleavage of lysine happens prior to digestion via mixing Lisdexamfetamine with digestive enzyme supplements, equaling D-amphetamine that can be used or sold as the pure drug D-amphetamine.

To date, I have not edited a wiki page, hence why I placed this in the talk section for criticism, instead of editing directly. This should be available to those seeking information on the misuse potential of the drug. This may end up being controversial considering that "low misuse potential" is one of the major perks the drug is advertised for.

SmarterThanILook (talk) 03:48, 4 March 2012 (UTC)

-Rephrase:

  Misuse of lisdexamfetamine may cause the same extent of cardiovascular side-effects as dextro-amphetamine, 

but again this risk is likely to be reduced due to the method of administration.

-Not needed, and lack of reference.

SmarterThanILook (talk) 21:58, 21 April 2012 (UTC)

Unreliable Source

This is cited:

http://healthlifeandstuff.com/2009/07/vyvanse-vs-adderall-simple-vs-complex/

And it really shouldn't be. I'll change it at some point if I have time (it's finals season), but I thought I should at least point it out.

Exercisephys (talk) 04:41, 5 December 2012 (UTC)

 Fixed