View Full Version : Vyvanse

11-30-09, 06:27 PM
My nephew was diagnosed with ADHD amongst other serious behavior problems. When he moved out to KS from FL his new Dr. put him on Vyvanse. He takes 100 mg every morning. I went to the FDA website and found out that the maximum dosage for an adult is 70 mg a day. My nephew is 11. The doc also has him on chlonidine & mitrazapine. Should I try to stay on my mom, his legal guardian, to get him a second diagnosis or is this the norm when it comes to kids with severe psychiatric disorders.

12-01-09, 12:18 PM
My son was recently diagnosed with ADHD combined type and was put on Vyvanse as well. He is on a 20mg once per day and that is the perfect dosage for him so far. That dosage seems a little high to me especially given his age and also the fact that Vyvanse is a long acting medication that stays in the system and working for up to 12 hours.
Was he taken to a regular doctor or was he taken to a psychologist or psychiatrist? If he was taken to a regular doctor, I would push her to take him to someone that is more specialized in treating children with problems like his.

What kind of side affects are you seeing with his medications? Is he zombied out? Overly emotional? Has he lost his appetite? Those are all warning signs that the dosage could possibly be too strong.

Good luck!

12-02-09, 01:09 AM
He has been seeing his neuropsychiatrist for a year and a half and has been on Vyvanse since the beginning. Yes sometimes he's zombie'd out, but most of the time he's bouncing off the walls. He is also definitely over emotional too. I read that this drug has only been on the market since July 2008 and it was only tested in 1000 people before its release. No one really knows exactly what the side & long term effects are. I do know however that he seems to be getting a lot more disengaged with everyday activities, but he is reading a lot more.:o

12-02-09, 12:53 PM
A neuropsych would be one of the specialty docs that have sufficient experience to manage med treatment for more challenging ADHD cases; so the doc is a good choice. Kids usually metabolize meds faster then adults and can need more to get a therapeutic dose. Prescribing outside the tested med ranges (off label) is part of the practice of medicine (which is where having a doc with lots of med management experience is useful).

The doc should be really explaining each step to your mom, along with what to expect and what to watch for so that she can be an active part of getting the best out of the treatment for your nephew. You might be able to help by letting your mom know what you observe that she may not be seeing. For instance, because I am at work when my daughter's meds are wearing off, I need to rely on others to let me know when her behavior changes and if she seems to be having issues at this time. This helps me talk to the doc about how effective treatment is and if we need to look into any changes. Is your nephew able to know when the meds are helping and when they are not? Some people can really help with their own med management but others do not know when the med is helping, while the people around them really notice the changes in behavior (reading, quite, active, scattered, etc.).

Usually, the most debilitating symptoms are treated the most aggressively, then treatment is modified to work for other symptoms, but without affecting treatment for the more debilitating symptoms. This means that some issues that would not normally be accepted are tolerated because the big issues are being handled first. It is really tough to find the best med regimen to cover all the needs of some people. Also their needs change as they get older and more optimization is needed.

Vyvanse is a pro-drug that is metabolized by the body to make amphetamine, which has been used a long time for ADHD treatment. It is supposed to last 10-12 hours to keep it to a single daily dose, and for many it has a smooth profile (not as noticable when it starts to work or wears off). If anxiety is present, stimulants may make them worse or even better, depending on the rood cause of the anxiety. The high dose may be what it takes to see long enough effectivity in a kid with high metabolism.

Sorry this is longer than I intended....

12-02-09, 02:27 PM
It would be worth knowing how they ended up with such a high dose. The other medications help with other issues. The clonidine helps calm the person during the "rebound" phase of the day. Likely the end of the day when the Vyvanse is wearing off. The Mertazipine, is a rarely used antidepressant. It has a range of side affects that can be helpfull for a person with ADHD. Namely, it helps with anxiety, increases appetite, and helps with sleep.

As noted above, Vyvanse is a new form of an ADHD medicine, but the active ingredient has been around for a long time. Most of these new meds are specialized "time release" formulas. That is what vyvanse is.