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Vyvanse vs Intuniv
Introduction
For patients with attention deficit hyperactivity disorder (ADHD), certain drugs that alter the concentrations of compounds in the brain linked to focus, impulse control and hyperactivity can help manage symptoms. Vyvanse and Intuniv are two such drugs prescribed for ADHD. They each impact different neurotransmitters in the brain but both have effects on managing ADHD symptoms. Vyvanse is a central nervous system stimulant, affecting levels of dopamine - a neurotransmitter associated with pleasure, movement, and attention span. On the other hand, Intuniv is classified as an alpha-2A adrenergic receptor agonist primarily affecting norepinephrine levels which play a role in attentiveness and impulsivity.
What is Vyvanse?
Lisdexamfetamine (the generic name for Vyvanse) was a significant development in the class of drugs known as stimulants. It was first approved by the FDA in 2007 and is prescribed primarily for treating Attention Deficit Hyperactivity Disorder (ADHD). Vyvanse is a prodrug, which means it's inactive until it undergoes metabolism within the body. This drug increases levels of dopamine and norepinephrine in the brain by blocking their reuptake, thereby enhancing focus and attention span.
On the other hand, Guanfacine (sold under brand name Intuniv among others), also used to treat ADHD but falls into a different class of medications called alpha-2a adrenergic receptor agonists. Approved by FDA in 2010 for use in children with ADHD, this medication works differently than Vyvanse; rather than influencing dopamine or norepinephrine directly, Guanfacine stimulates receptors that help to reduce hyperactivity and improve impulse control.
Although both are effective treatments for ADHD, they work differently and may produce varying side effects. Consultation with medical professionals can guide you toward choosing the best option based on individual needs.
What conditions is Vyvanse approved to treat?
Vyvanse is approved for the treatment of several conditions:
- Attention Deficit Hyperactivity Disorder (ADHD) in both children and adults
- Moderate to severe Binge Eating disorder (BED) in adults
On the other hand, Intuniv is specifically indicated as part of a total treatment program that includes psychological, educational and social measures to treat:
- ADHD as monotherapy or adjunctive therapy to stimulant medications. It is not intended for use in treating patients with hypertension.
How does Vyvanse help with these illnesses?
Vyvanse helps to manage ADHD by increasing the amount of dopamine and norepinephrine in the synapses of the brain. It does this by triggering their release into the synaptic cleft, which means levels can be maintained higher for longer periods of time. Both dopamine and norepinephrine are neurotransmitters, chemicals that act as messengers in the brain and throughout the body. They play crucial roles in attention, focus, impulse control, executive function and mental flexibility among other things. It is thought that individuals with ADHD have relatively lower levels or an imbalance of these neurotransmitters. Therefore, by boosting their levels via Vyvanse administration can help mitigate some negative effects of ADHD and aid patients better manage their condition.
On the other hand, Intuniv works differently from Vyvanse; it acts on alpha-2A adrenergic receptors located mainly within prefrontal areas responsible for working memory capacity, behavioral inhibition (impulse control), attention regulation along with cognitive flexibility among others - all problematic domains in people suffering from ADHD.
What is Intuniv?
Intuniv is a brand name for guanfacine, which operates as an alpha-2A adrenergic receptor agonist. This means that it enhances the action of norepinephrine in certain parts of the brain by stimulating these receptors. Guanfacine was first approved by the FDA in 2010 specifically for ADHD treatment. Unlike Vyvanse, Intuniv is not a stimulant but rather falls into the category of non-stimulant medications used to treat ADHD. It does not increase levels of dopamine and norepinephrine; instead, its mode of action involves reducing hyperactive signals in the prefrontal cortex area of the brain thereby improving attention span and reducing impulsivity and distractibility—common symptoms associated with ADHD. As Intunif does not stimulate an influx of neurotransmitters like Vyvanse (which is actually a prodrug), its side effect profile differs significantly from stimulants: it generally doesn't cause insomnia or decreased appetite commonly associated with drugs like Vyvanse. The effects on select norepinephrine receptors can be particularly beneficial for treating children with ADHD who may respond adversely to typical stimulant-based treatments such as Vyvanse.
What conditions is Intuniv approved to treat?
Intuniv has been approved by the FDA to treat attention deficit hyperactivity disorder (ADHD) in children and adolescents. Unlike other ADHD medications, Intuniv is not a stimulant but rather works by stimulating receptors in the prefrontal cortex of the brain which help control impulsivity and attention span. The following conditions can be treated with Intuniv:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Oppositional defiant disorder (when used alongside other treatments).
How does Intuniv help with these illnesses?
Intuniv, unlike Vyvanse, works by mimicking the actions of norepinephrine in the body and brain. Norepinephrine is a neurotransmitter that plays pivotal roles in many processes such as wakefulness, memory recall, focus and attention and is heavily involved in the “fight or flight” response to prepare the body for action under stress. Intuniv specifically targets receptors in certain parts of the brain associated with ADHD symptoms improving executive functioning including working memory, impulse control and emotional regulation. Additionally, this drug does not have any significant effect on dopamine levels which reduces potential side effects related to mood instability or addictive behaviors. Hence it might be prescribed when patients do not respond well to traditional stimulant medications such as Vyvanse or may even be used together with these drugs to enhance symptom management.
How effective are both Vyvanse and Intuniv?
Both lisdexamfetamine (Vyvanse) and guanfacine (Intuniv) have established histories of success in treating patients with ADHD, and they were initially approved by the FDA a few years apart. Since they act on different neurotransmitters, they may be prescribed under different circumstances. The effectiveness of Vyvanse and Intuniv in managing symptoms of ADHD was directly compared in several clinical trials; the two drugs exhibited similar efficacy in mitigating symptoms as well as promising safety profiles.
A 2007 review on lisdexamfetamine demonstrated that it is effective at reducing symptoms of ADHD from the first dose onward, that its side effect profile is favorable over many other stimulants, and it has been well-tolerated even in pediatric populations. As an amphetamine prodrug developed to provide longer-lasting symptom control throughout the day while minimizing abuse potential, there is significant history studying its effectiveness for ADHD treatment. The optimal dosage varies widely among individuals but often starts at 30mg/day.
In comparison, a 2016 meta-analysis indicated that guanfacine seems to be more effective than placebo in managing hyperactivity/impulsivity symptoms but less so for attention deficits. However, Intuniv tends to be considered an adjunct or alternative treatment option after stimulant medications due to slower onset action and lesser impact on cognitive function relative to stimulants like Vyvanse. Nonetheless, due to its unique pharmacology affecting alpha-2a adrenergic receptors resulting in reduced noradrenaline availability hence calming effect without significant risk for substance misuse makes it ideal for those prone to tic disorders or who did not respond well or cannot tolerate side effects associated with CNS stimulant treatments such as sleep disturbances or appetite loss.
At what dose is Vyvanse typically prescribed?
Oral dosages of Vyvanse range from 30–70 mg/day, but studies have indicated that 30 mg/day is often sufficient for treating Attention Deficit Hyperactivity Disorder (ADHD) in most people. Children and adolescents may be started on a dose of 20 mg/day. In either population, dosage can be increased after one week if there is no response. The maximum dosage that should not be exceeded in any case is 70 mg/day.
On the other hand, Intuniv doses start at lower levels—1mg per day—and are adjusted up to a possible maximum of 4mg per day depending on efficacy and tolerability. This medication is designed specifically for children between the ages of six and seventeen with ADHD symptoms.
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At what dose is Intuniv typically prescribed?
Intuniv treatment is typically started at a dosage of 1 mg/day. The dose can then be gradually increased, usually by adding 1 mg per week, until an optimal response is achieved. Dosage may range from 1 to 7 mg once daily, taken in the morning or evening at approximately the same time each day. The maximum dose tested for ADHD in clinical studies was 4 mg per day; doses higher than this have not been systematically studied and are therefore not recommended. If there's no significant improvement seen after several weeks of treatment at appropriate dosages, re-evaluation might be necessary as the medication should show a clear therapeutic benefit within this period when used correctly.
What are the most common side effects for Vyvanse?
Common side effects of Vyvanse can include:
- Anxiety
- Decreased appetite, leading to weight loss
- Diarrhea, nausea or vomiting
- Dizziness
- Dry mouth
- Irritability and restlessness
- Insomnia (trouble sleeping)
- Increased heart rate and blood pressure
- Sweating excessively
- Unusual tiredness or weakness
In comparison, the most frequently experienced side effects with Intuniv are:
-Somnolence (sleepiness/drowsiness)
-Dry mouth
-Stomach pain or discomfort/ indigestion
-Nausea,
-Decrease in blood pressure when changing position.
-Lethargy (lack of energy)
-Fatigue.
-Conjunctivitis (pink eye)
It's important to remember that these lists do not contain all possible side effects. Always consult your healthcare provider for advice about a specific medical condition.
Are there any potential serious side effects for Vyvanse?
While both Vyvanse and Intuniv are used to treat ADHD, they can have different side effects:
- An increased risk of suicidal thoughts or actions
- Signs of an allergic reaction: hives; difficulty breathing; swelling in your face, lips, tongue, or throat
- Changes in vision including blurred vision; eye pain or redness; seeing halos around lights
- Unusual changes in behavior (being overly active/aggressive/restless/irritable)
- Fast/pounding heartbeat; shortness of breath especially when this is new for you
- Low sodium levels - symptoms may include headache, weakness/spasms/cramps/stiff muscles, confusion/delirium/slow thinking/slurred speech/hallucinations/seizures/coma.
In addition to these common adverse reactions associated with the therapeutic use of Vyvanse and Intuniv,
Vyvanse-specific side effects also might include Severe nervous system reaction – very stiff (rigid) muscles, high fever, sweating/confusion/fast/uneven heartbeats/tremors
Intuniv-specific side effects also might include Any symptoms related to low blood pressure like dizziness/lightheadedness/fainting/syncope especially while standing up from a sitting position.
Both medications should be taken only as directed by a healthcare provider. If any unusual symptoms occur while taking either medication consult immediately.
What are the most common side effects for Intuniv?
Choosing the right medication is crucial, and understanding side effects can help with this. Intuniv is a non-stimulant treatment for ADHD, and while it's generally well-tolerated, it does have potential side effects to be aware of:
- Drowsiness or fatigue: This drug can make you feel very tired or sleepy.
- Dry mouth: Some users experience excessive thirst or dryness in their mouth.
- Stomach pain/constipation: Intuniv has been known to cause digestive issues including stomach pain and constipation.
- Slow heartbeat (bradycardia): Unlike stimulant medications which often increase heart rate, Intuniv actually slows down the pulse.
- Blood pressure changes: The medicine may lead to a decrease in blood pressure upon standing up too quickly from sitting or lying position.
- Headache/Dizziness: These are common reactions that usually lessen over time as your body adjusts to the medication.
It’s worth noting that not everyone will experience these side-effects with Intuniv - everyone reacts differently to different medications. Always consult your doctor for advice tailored specifically for you.
Are there any potential serious side effects for Intuniv?
While Intuniv is usually well-tolerated, it can sometimes lead to serious side effects. These may include:
- Indications of an allergic reaction: hives, itching, fever, swollen glands; difficulty in breathing; swelling in your face or throat.
- Heart-related issues: slow heartbeat (bradycardia), low blood pressure (hypotension), fainting or feeling lightheaded when standing up from a sitting or lying position.
- Mental/mood changes: new or worsening mental/mood/behavior changes such as depression, irritability, thoughts about suicide/self-harm.
- Severe nausea/vomiting/diarrhea/constipation
- Signs of liver disease like dark urine and yellowing eyes/skin
If you experience any of these symptoms while taking Intuniv, it's crucial that you seek immediate medical attention. It’s also worth noting that abruptly stopping this medication may cause withdrawal reactions such as increased heart rate and high blood pressure. Always consult with your healthcare provider before making any changes to the dosage regimen.
Contraindications for Vyvanse and Intuniv?
Both Vyvanse and Intuniv, along with most other ADHD medications, may exacerbate symptoms in some people. If you notice your anxiety heightening, or an increase in suicidal ideation, thoughts, or behavior while taking these medications, please seek immediate medical attention.
Neither Vyvanse nor Intuniv should be taken if you are currently on monoamine oxidase (MAO) inhibitors (MAOIs), or have been on them recently. Always inform your physician about the drugs you're presently taking; MAOIs will require a period of approximately 2 weeks to clear from the system to prevent dangerous interactions with Vyvanse and Intuniv.
How much do Vyvanse and Intuniv cost?
For the brand name versions of these drugs:
- The price of 30 capsules of Vyvanse (40 mg) averages around $363, which works out to approximately $12/day.
- The price for 100 tablets of Intuniv (1 mg) is about $570, working out to roughly $5.70/day.
Thus, if you are in a higher dosage range for Vyvanse (i.e., 60–70 mg/day), then brand-name Intuniv might be less expensive on a per-day treatment basis. Please note that cost should not be your primary consideration when determining which medication is right for you.
Generic versions can also help save costs significantly:
- Currently there's no generic version available for Vyvanse.
- Guanfacine ER, the generic form of Intuniv, comes in packs ranging from 30 to 90 tablets. Costs vary between about $0.50 and $3.00 per day depending on dose and quantity purchased upfront — typically much cheaper than its branded counterpart.
Remember always consult with healthcare providers before making any decisions regarding medications as they can provide personalized advice based on your health history and current condition.
Popularity of Vyvanse and Intuniv
Lisdexamfetamine, available under the brand name Vyvanse, was estimated to have been prescribed to about 10.5 million people in the US in 2020. Lisdexamfetamine accounted for roughly 16% of prescriptions for Attention Deficit Hyperactivity Disorder (ADHD) medications. It's a central nervous system stimulant that works by affecting chemicals in the brain and nerves contributing to hyperactivity and impulse control.
On the other hand, Guanfacine - including its extended-release formulation Intuniv - was prescribed to approximately 1.2 million individuals in the USA during the same period. Accounting for around 2% of ADHD medication prescriptions, Guanfacine is a non-stimulant treatment option with a different mechanism from stimulants like lisdexamfetamine; it acts on part of the brain (the prefrontal cortex) responsible for attention and impulse response. The use of Guanfacine has also seen an upward trend since its approval as an ADHD medication.
Conclusion
Both Vyvanse (lisdexamfetamine) and Intuniv (guanfacine) have well-established profiles in managing Attention Deficit Hyperactivity Disorder (ADHD), supported by numerous clinical trials asserting their effectiveness over placebo treatments. Occasionally, these drugs may be used in tandem, but this decision is subject to careful consideration by a physician as they act on different neurotransmitter systems - Vyvanse primarily increases levels of dopamine and norepinephrine while Intuniv selectively stimulates receptors for norepinephrine.
Vyvanse is often the first-line treatment due to its robust efficacy data, whereas Intuniv might be added as an adjunctive therapy or prescribed alone when patients are unable to tolerate stimulants or need to avoid common side-effects such as appetite suppression and insomnia associated with them like Vyvanse.
Both medications come in generic forms that can notably reduce costs for patients who pay out-of-pocket. An adjustment period may be required for both Vyvanse and Intuniv where effects aren't immediately noticeable.
The side effect profile between the two drugs differ. While both are generally well-tolerated, Vyvanse can cause more jitteriness or restlessness than Intuniv which can lead to sedation/sleepiness. It's crucial that patients closely monitor any changes especially at the beginning of treatment and seek immediate medical attention if adverse reactions occur.