Vyvanse Tapering Guide
lisdexamfetamine
Boxed Warning
High potential for abuse and dependence — Schedule II. Misuse may cause sudden death or serious cardiovascular events.
Overview
Lisdexamfetamine is a prodrug of dextroamphetamine — inactive until enzymatically cleaved in the gut and bloodstream. Designed for once-daily dosing with reduced abuse liability vs immediate-release amphetamine. Schedule II.
10mg, 20mg, 30mg, 40mg, 50mg, 60mg, 70mg capsules; 10-60mg chewable
Capsules: 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, 70mg; Chewable tablets: 10mg, 20mg, 30mg, 40mg, 50mg, 60mg
Category C
Mechanism of Action
After cleavage, dextroamphetamine releases dopamine and norepinephrine, blocks reuptake, and inhibits VMAT2.
Taper Notes
Step down by capsule strength over 1-3 weeks.
Hyperbolic Tapering Guidance
Same considerations as methylphenidate. The prodrug structure does not eliminate dependence — it slows abuse-pattern dosing.
Summary written by TaperCommunity, informed by the Maudsley Deprescribing Guidelines (Horowitz & Taylor) and related literature — see Sources & References below. Not affiliated with or endorsed by the Maudsley.
Withdrawal Timeline
1-2 days after stopping
3-7 days
1-3 weeks
Anhedonia and motivation deficits can persist 3-8 weeks
Common Withdrawal Symptoms
Interactions & Safety
Drug Interactions
- Same as amphetamine: MAOIs contraindicated, additive sympathomimetic effects, etc.
Contraindications
- Recent MAOI use
- Advanced cardiovascular disease
- Hyperthyroidism
Toxicity
Same class effects as amphetamine: anorexia, insomnia, hypertension, tachycardia, anxiety, psychosis, growth suppression, abuse and dependence.
Pharmacokinetics
ADME Profile
Hydrolyzed by red-blood-cell enzymes to dextroamphetamine, then hepatic.
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Other Drug Profiles
Sources & References
Vyvanse (lisdexamfetamine) information on this page is sourced from peer-reviewed research, regulatory bodies, clinical guidelines, and patient-advocacy organizations.
Encyclopedic & chemical databases
Neutral, high-authority entity references.
Regulatory sources
Official prescribing information and safety notices.
Peer-reviewed research
Primary literature cited in this taper guide.
- Wilens TE, Adler LA, Adams J, et al. 2008 — Misuse and diversion of stimulants prescribed for ADHD (Journal of the American Academy of Child & Adolescent Psychiatry)
- Davies J, Read J 2019 — A systematic review into the incidence, severity and duration of antidepressant withdrawal effects (Addictive Behaviors)
Clinical guidelines
Evidence-based deprescribing and prescribing standards.
Deprescribing-specific resources
Clinician-facing references on tapering protocols.
- Deprescribing.org — Clinician-facing deprescribing algorithms
- Royal College of Psychiatrists — ADHD resources — UK clinical guidance on adult ADHD pharmacotherapy
Patient-advocacy & lived-experience
Long-running communities documenting withdrawal experience.
- Mad in America — stimulant coverage — Independent journalism on stimulant prescribing and discontinuation
- Inner Compass Initiative — Withdrawal Project — Peer-led psychiatric drug withdrawal resources
- Surviving Antidepressants — other medications forum — Community discussion of stimulant taper experiences
- RxISK — adverse drug reaction reporting — Independent database of stimulant adverse-effect reports
TaperCommunity does not provide medical advice. Always consult a qualified prescriber before adjusting psychiatric medication.