Lisdexamfetamine: Difference between revisions

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'''Lisdexamfetamine''' (also known as '''lisdextroamphetamine''', '''L-lysine-dextroamphetamine''', or '''lisdexamfetamine dimesylate''' when under the brand names '''Elvanse''', '''Tyvense''', and '''Vyvanse''') is a [[psychoactive class::stimulant]] substance of the [[~~chemical~~ class~~::amphetamine~~]] ~~class~~. It is a ~~"mutual [[prodrug]]" (~~[https://en.wikipedia.org/wiki/Codrug codrug]) for [[dextroamphetamine]] that is approved for the treatment of attention deficit hyperactivity disorder (ADHD) and moderate to severe binge-eating disorder.<ref>https://www.drugs.com/pro/vyvanse.html</ref> Like [[amphetamine]], lisdexamfetamine produces its effects by promoting the release of [[neurotransmitters]] [[dopamine]] and [[norepinephrine]] in the brain.

'''Lisdexamfetamine''' (also known as '''lisdextroamphetamine''', '''L-lysine-dextroamphetamine''', or '''lisdexamfetamine dimesylate''' when under the brand names '''Elvanse''', '''Tyvense''', and '''Vyvanse''') is a [[psychoactive class::stimulant]] substance of the [[amphetamines|amphetamine class]]. It is a [https://en.wikipedia.org/wiki/Codrug codrug] for [[dextroamphetamine]] that is approved for the treatment of attention deficit hyperactivity disorder (ADHD) and moderate to severe binge-eating disorder.<ref>https://www.drugs.com/pro/vyvanse.html</ref> Like [[amphetamine]], lisdexamfetamine produces its effects by promoting the release of [[neurotransmitters]] [[dopamine]] and [[norepinephrine]] in the brain.

[[Subjective effects]] are essentially identical to that of [[dextroamphetamine]] except with a slower onset and a longer duration. These include [[stimulation]] (in a small percent of the population paradoxal [[sedation]]), [[focus enhancement]], [[motivation enhancement]], [[euphoria]], and in a smaller population . However, unlike [[dextroamphetamine]], lisdexamfetamine was specifically designed to prevent non-oral forms of administration (marketed as an anti-abuse design). This means that [[insufflation]], [[Route of administration#Smoked|smoking]] or [[Route of administration#Injection|injection]] do not provide faster absorption or onset. It is sometimes sold and used illicitly as a "study drug" as well as a recreational substance.

Despite the marketed anti-abuse design, many users report that lisdexamfetamine is capable of producing dependence and addiction like other [[~~euphoric~~]] stimulants, particularly when it is taken above the recommended dosage. As a result, it is highly advised to use [[harm reduction practices]] if using this substance.

Despite the marketed anti-abuse design, many users report that lisdexamfetamine is capable of producing dependence and addiction like other [[euphoria]] inducing [[stimulants]], particularly when it is taken above the recommended dosage. As a result, it is highly advised to use [[harm reduction practices]] if using this substance.

==History and culture==

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}}

|{{effects/cognitive|

Lisdexamfetamine shares most of its cognitive effects with other amphetamines, although it is less forceful in its come up due to the slow release mechanism. It produces a variety of cognitive enhancements associated with [[stimulants]]. However, during the latter part of the duration, these cognitive enhancements may compete with or be nullified by the accumulated dopamine depletion and its effects.

Lisdexamfetamine shares most of its cognitive effects with other [[amphetamines]], although it is less forceful in its come up due to the slow release mechanism. It produces a variety of cognitive enhancements associated with [[stimulants]]. However, during the latter part of the duration, these cognitive enhancements may compete with or be nullified by the accumulated dopamine depletion and its effects.

The most prominent of these cognitive effects generally include:

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{{effects/auditory|

*'''[[Effect::Auditory enhancement|Enhancements]]'''

*'''[[Effect::Auditory hallucinations|Hallucinations]]''' - Use of lisdexamfetamine and other amphetamines, at a strong or heavy dose, can occasionally cause mild auditory hallucinations. These hallucinations most commonly occur amongst a source of white noise, such as a fan, and typically consist of quiet phantom music or voices. Lisdexamfetamine may also cause auditory hallucinations in the form of [[stimulant psychosis]].

*'''[[Effect::Auditory hallucinations|Hallucinations]]''' - Use of lisdexamfetamine and other [[amphetamines]], at a strong or heavy dose, can occasionally cause mild auditory hallucinations. These hallucinations most commonly occur amongst a source of white noise, such as a fan, and typically consist of quiet phantom music or voices. Lisdexamfetamine may also cause auditory hallucinations in the form of [[stimulant psychosis]].

}}

{{effects/aftereffects|

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==Toxicity and Harm Potential==

In rodents and primates, sufficiently high doses of [[amphetamine]] cause dopaminergic neurotoxicity, or damage to dopamine neurons, which is characterized by reduced transporter and receptor function. There is no evidence that [[amphetamine]] is directly neurotoxic in humans. However, large doses of [[amphetamine]] may cause indirect neurotoxicity as a result of increased oxidative stress from reactive oxygen species and autoxidation of [[dopamine]].

In rodents and primates, sufficiently high doses of [[amphetamine]] cause dopaminergic neurotoxicity, or damage to [[dopamine]] neurons, which is characterized by reduced transporter and receptor function. There is no evidence that [[amphetamine]] is directly [[neurotoxic]] in humans. However, large doses of [[amphetamine]] may cause indirect [[neurotoxicity]] as a result of increased oxidative stress from reactive oxygen species and autoxidation of [[dopamine]].

It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this drug.

===Tolerance and addiction potential===

Addiction is a serious risk with heavy recreational [[amphetamine]] use but is unlikely to arise from typical long-term medical use at therapeutic doses. Lisdexamfetamine has been posited to have less potential for abuse and addiction than other pharmaceutical amphetamines due to the slower onset and the self-limiting metabolism, which puts a cap on the maximum peak plasma concentration and consequent dopamine release. Caution is nonetheless advised, as with other drugs in the amphetamine class.

Addiction is a serious risk with heavy recreational [[amphetamine]] use but is unlikely to arise from typical long-term medical use at therapeutic doses. Lisdexamfetamine has been posited to have less potential for abuse and addiction than other pharmaceutical [[amphetamines]] due to the slower onset and the self-limiting metabolism, which puts a cap on the maximum peak plasma concentration and consequent dopamine release. Caution is nonetheless advised, as with other drugs in the [[amphetamines|amphetamine class]].

Tolerance develops rapidly in [[amphetamine]] abuse (i.e. a recreational amphetamine overdose), so periods of extended use require increasingly larger doses of the drug in order to achieve the same effect. Repeated use of lisdexamfetamine will result in a gradual tolerance proportional to the dosage taken. Patients prescribed this drug often must increase their dosage after a time to maintain its efficacy.

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 {{SummarySheet}}
 {{SubstanceBox/Lisdexamfetamine}}
-'''Lisdexamfetamine''' (also known as '''lisdextroamphetamine''', '''L-lysine-dextroamphetamine''', or '''lisdexamfetamine dimesylate''' when under the brand names '''Elvanse''', '''Tyvense''', and '''Vyvanse''') is a [[psychoactive class::stimulant]] substance of the [[chemical class::amphetamine]] class. It is a "mutual [[prodrug]]" ([https://en.wikipedia.org/wiki/Codrug codrug]) for [[dextroamphetamine]] that is approved for the treatment of attention deficit hyperactivity disorder (ADHD) and moderate to severe binge-eating disorder.<ref>https://www.drugs.com/pro/vyvanse.html</ref> Like [[amphetamine]], lisdexamfetamine produces its effects by promoting the release of [[neurotransmitters]] [[dopamine]] and [[norepinephrine]] in the brain.
+'''Lisdexamfetamine''' (also known as '''lisdextroamphetamine''', '''L-lysine-dextroamphetamine''', or '''lisdexamfetamine dimesylate''' when under the brand names '''Elvanse''', '''Tyvense''', and '''Vyvanse''') is a [[psychoactive class::stimulant]] substance of the [[amphetamines|amphetamine class]]. It is a [https://en.wikipedia.org/wiki/Codrug codrug] for [[dextroamphetamine]] that is approved for the treatment of attention deficit hyperactivity disorder (ADHD) and moderate to severe binge-eating disorder.<ref>https://www.drugs.com/pro/vyvanse.html</ref> Like [[amphetamine]], lisdexamfetamine produces its effects by promoting the release of [[neurotransmitters]] [[dopamine]] and [[norepinephrine]] in the brain.
 [[Subjective effects]] are essentially identical to that of [[dextroamphetamine]] except with a slower onset and a longer duration. These include [[stimulation]] (in a small percent of the population paradoxal [[sedation]]), [[focus enhancement]], [[motivation enhancement]], [[euphoria]], and in a smaller population . However, unlike [[dextroamphetamine]], lisdexamfetamine was specifically designed to prevent non-oral forms of administration (marketed as an anti-abuse design). This means that [[insufflation]], [[Route of administration#Smoked|smoking]] or [[Route of administration#Injection|injection]] do not provide faster absorption or onset. It is sometimes sold and used illicitly as a "study drug" as well as a recreational substance.
-Despite the marketed anti-abuse design, many users report that lisdexamfetamine is capable of producing dependence and addiction like other [[euphoric]] stimulants, particularly when it is taken above the recommended dosage. As a result, it is highly advised to use [[harm reduction practices]] if using this substance.
+Despite the marketed anti-abuse design, many users report that lisdexamfetamine is capable of producing dependence and addiction like other [[euphoria]] inducing [[stimulants]], particularly when it is taken above the recommended dosage. As a result, it is highly advised to use [[harm reduction practices]] if using this substance.
 ==History and culture==
@@ Line 79: / Line 79: @@
 }}
 |{{effects/cognitive|
-Lisdexamfetamine shares most of its cognitive effects with other amphetamines, although it is less forceful in its come up due to the slow release mechanism. It produces a variety of cognitive enhancements associated with [[stimulants]]. However, during the latter part of the duration, these cognitive enhancements may compete with or be nullified by the accumulated dopamine depletion and its effects.
+Lisdexamfetamine shares most of its cognitive effects with other [[amphetamines]], although it is less forceful in its come up due to the slow release mechanism. It produces a variety of cognitive enhancements associated with [[stimulants]]. However, during the latter part of the duration, these cognitive enhancements may compete with or be nullified by the accumulated dopamine depletion and its effects.
 The most prominent of these cognitive effects generally include:
@@ Line 106: / Line 106: @@
 {{effects/auditory|
 *'''[[Effect::Auditory enhancement|Enhancements]]'''
-*'''[[Effect::Auditory hallucinations|Hallucinations]]''' - Use of lisdexamfetamine and other amphetamines, at a strong or heavy dose, can occasionally cause mild auditory hallucinations. These hallucinations most commonly occur amongst a source of white noise, such as a fan, and typically consist of quiet phantom music or voices. Lisdexamfetamine may also cause auditory hallucinations in the form of [[stimulant psychosis]].
+*'''[[Effect::Auditory hallucinations|Hallucinations]]''' - Use of lisdexamfetamine and other [[amphetamines]], at a strong or heavy dose, can occasionally cause mild auditory hallucinations. These hallucinations most commonly occur amongst a source of white noise, such as a fan, and typically consist of quiet phantom music or voices. Lisdexamfetamine may also cause auditory hallucinations in the form of [[stimulant psychosis]].
 }}
 {{effects/aftereffects|
@@ Line 131: / Line 131: @@
 ==Toxicity and Harm Potential==
-In rodents and primates, sufficiently high doses of [[amphetamine]] cause dopaminergic neurotoxicity, or damage to dopamine neurons, which is characterized by reduced transporter and receptor function. There is no evidence that [[amphetamine]] is directly neurotoxic in humans. However, large doses of [[amphetamine]] may cause indirect neurotoxicity as a result of increased oxidative stress from reactive oxygen species and autoxidation of [[dopamine]].
+In rodents and primates, sufficiently high doses of [[amphetamine]] cause dopaminergic neurotoxicity, or damage to [[dopamine]] neurons, which is characterized by reduced transporter and receptor function. There is no evidence that [[amphetamine]] is directly [[neurotoxic]] in humans. However, large doses of [[amphetamine]] may cause indirect [[neurotoxicity]] as a result of increased oxidative stress from reactive oxygen species and autoxidation of [[dopamine]].
 It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this drug.
 ===Tolerance and addiction potential===
-Addiction is a serious risk with heavy recreational [[amphetamine]] use but is unlikely to arise from typical long-term medical use at therapeutic doses. Lisdexamfetamine has been posited to have less potential for abuse and addiction than other pharmaceutical amphetamines due to the slower onset and the self-limiting metabolism, which puts a cap on the maximum peak plasma concentration and consequent dopamine release. Caution is nonetheless advised, as with other drugs in the amphetamine class.
+Addiction is a serious risk with heavy recreational [[amphetamine]] use but is unlikely to arise from typical long-term medical use at therapeutic doses. Lisdexamfetamine has been posited to have less potential for abuse and addiction than other pharmaceutical [[amphetamines]] due to the slower onset and the self-limiting metabolism, which puts a cap on the maximum peak plasma concentration and consequent dopamine release. Caution is nonetheless advised, as with other drugs in the [[amphetamines|amphetamine class]].
 Tolerance develops rapidly in [[amphetamine]] abuse (i.e. a recreational amphetamine overdose), so periods of extended use require increasingly larger doses of the drug in order to achieve the same effect. Repeated use of lisdexamfetamine will result in a gradual tolerance proportional to the dosage taken. Patients prescribed this drug often must increase their dosage after a time to maintain its efficacy.