Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN
Written By: Phillippe Greenough
Article Updated: 01/25/2021
Number of References: 17 Sources
Vyvanse is a powerful amphetamine medication that, while it is was designed to prevent abuse, can still be addictive. The symptoms of Vyvanse withdrawal can last for several weeks, or even months, and may include anxiety, depression, sleep disturbances, and strong cravings for Vyvanse. In this article, we dive into Vyvanse addiction and withdrawal and detail the specific symptoms of Vyvanse withdrawal, the timeline involved, effective treatments, and much more.
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The symptoms of Vyvanse withdrawal are similar to those of other amphetamines and are strictly psychological in nature. While this may seem minor, these symptoms should not be underestimated. The depression that is common during withdrawal can sometimes be severe, leading to thoughts of suicide and, unfortunately, suicide attempts. These symptoms are usually most severe in the days or weeks immediately after ceasing Vyvanse use, but may often persist for many months or even years.
With many stimulants, including Vyvanse, there is really no difference between the acute and post-acute phases of withdrawal due to the lack of physical symptoms. That being said, there is often a “crash” that occurs in the days immediately after the last time someone used Vyvanse, although this usually improves somewhat within the first week. Following the crash and improvement, there is often a stabilization of symptoms as they gradually improve over time. The amount of time before a full recovery can vary between people, sometimes by a great deal. There are also many contributing factors to both the intensity and the duration of Vyvanse withdrawal symptoms as we will explore later.
The timeline for Vyvanse withdrawal can be a long one, although the symptoms diminish with time and abstinence from Vyvanse or other drugs. There is quite a bit of variation in this timeline between people as well, but for now, we will stick to an average and generalized timeline. With the symptoms being psychological in nature, there is no clear “finish line” for the end of acute withdrawal, as Vyvanse has no medically recognized acute withdrawal syndrome. The current view of stimulant withdrawal syndromes is that they exhibit a crash phase, a withdrawal phase, and finally an extinction phase although the duration of each of these can vary between stimulants. The symptoms of Vyvanse withdrawal are quite similar throughout the majority of the withdrawal timeline although some may reduce more quickly and resolve sooner than others.
Vyvanse, and more specifically dextroamphetamine, has a fairly average half-life as far as stimulants go at roughly 12 hours. The fact that Vyvanse is technically lisdexamfetamine may add an hour to this half-life, as it takes time for lisdexamfetamine to break down into L-lysine and dextroamphetamine. This means that in an average user, someone will begin to experience symptoms of Vyvanse withdrawal between 16 to 24 hours since the last time they used the drug.
Within a day or so of the last Vyvanse use, symptoms of Vyvanse withdrawal will begin to emerge. The crash phase can be quite abrupt and will leave someone feeling extremely drained of energy, both in a mental and physical sense. It is common for someone to sleep for long stretches at a time in the first few days after the crash has begun. Their appetite may be increased as well and strong cravings for Vyvanse may be common during this time. Thinking often seems clouded, disorganized, and difficult during this time as well. Depression often emerges next, and anhedonia can leave someone with a reduced or totally absent ability to experience pleasure of any kind during early Vyvanse withdrawal. Anxiety is likely to emerge during this time as well. Towards the middle of the first week, the crash will usually improve somewhat and enter proper withdrawal. The cravings, anxiety, depression, and fatigue levels will still be present but may improve slightly. Irritability may increase around this time as well.
Some symptoms of Vyvanse withdrawal that someone may experience during the first week could include:
The beginning of the second week may mark a change in the symptoms of Vyvanse withdrawal, as the crash has, by this time, become standard withdrawal. Hypersomnia can often change to insomnia as anxiety, restlessness, and vivid dreams or nightmares can make sleep difficult or elusive. Appetite may begin returning to normal as someone’s mood slowly improves, and energy levels will remain quite low all around. Irritability and aggression may increase somewhat, and insomnia may exacerbate these symptoms. Clouded or disorganized thinking is usually still present, and cravings may increase throughout the week. Aside from cravings, the other symptoms may see slight improvement during the second week, but these improvements are often minimal at best.
Some symptoms that may be expected during the second week of Vyvanse withdrawal could include:
The third week may mark some improvements in symptoms as the week progresses. While the beginning of the week may still be marked by insomnia and sleep disturbances in the form of nightmares or vivid dreams, these often fade as the week wears on. Irritability may reduce somewhat as well, although depression, anxiety, cravings, and fatigue are often relatively unchanged. Clarity of thought may improve somewhat throughout the week as well, with someone better able to remember, follow conversations, and think ahead in a more structured and organized manner. Additionally, anhedonia may begin to lift somewhat throughout the week, and things that once brought joy or pleasure may be able to do so again, although it is usually minor.
Some symptoms that may be expected to persist into the third week of Vyvanse withdrawal may include:
By the fourth week after the last Vyvanse use, the symptoms are often moderately improved. Sleep may be almost back to normal and the vivid dreams or nightmares may be fewer and farther in between. Irritability may still be moderate, and it is common for cravings, depression, and anxiety to still be present. Energy levels may have improved somewhat, but are still often low. This is the time when treatment should absolutely be sought if this hasn’t been done already. The worst stage of withdrawal may be in the past, but symptoms often persist for at least several weeks and possibly even for months or years. The risk of relapse is real, and the repercussions can be severe as most overdose deaths occur in previous Vyvanse users who have some time sober but return to using the same amount they were using when they stopped. Further treatment and care can reduce the risk of relapse and improve someone’s state of mind and outlook on life without Vyvanse.
Some symptoms of Vyvanse withdrawal that may linger into the fourth week can include:
The symptoms of Vyvanse withdrawal can exhibit some substantial variability between people, and this can be due to a variety of factors. Some of these are based on Vyvanse use habits and are therefore based on choices someone has made while others have to do with mental health or genetics and are totally out of someone’s power to control. Depending on these factors, both the intensity and the duration of Vyvanse withdrawal symptoms can be affected. While some people may recover fully and quickly from withdrawal, others may have severe and long-lasting symptoms that can persist for years.
Some of the factors that can contribute greatly to both the intensity and duration of Vyvanse withdrawal symptoms include:
Certainly, the largest factor with regard to the intensity and duration of Vyvanse withdrawal symptoms are a person’s specific Vyvanse use habits. The amount of Vyvanse someone regularly used can directly impact the intensity of withdrawal symptoms. The more Vyvanse someone uses, the more dopamine and norepinephrine receptor downregulation occurs. Once someone stops using Vyvanse, the more severe the symptoms will be. Additionally, the longer someone used Vyvanse, the longer the withdrawal symptoms will last once they do stop using. After downregulation begins, a further process of remodeling begins. The longer someone uses Vyvanse, the more complete this remodeling process becomes. Remodeling will take time to produce noticeable effects and is a very slow process to complete and, likewise, a very slow process to reverse. The longer someone used Vyvanse, the longer they can expect to experience withdrawal symptoms after they stop using the drug.
If someone had pre-existing mental health issues such as depression or anxiety, then they may have more severe depressive or anxious symptoms during withdrawal. Additionally, these symptoms may be more persistent in there were co-occurring mental health issues. Since depression and anxiety are such common symptoms of Vyvanse withdrawal, these two were highlighted, but this could occur with a variety of mental illnesses.
Genetics certainly plays a factor in someone’s likelihood to suffer from addiction issues, although the way it may affect Vyvanse withdrawal symptoms is very indirect and tangential. If someone has a genetic predisposition for addiction, then they may be more likely to abuse Vyvanse earlier in life, which could lead to developmental issues, and they may have a higher likelihood of persistent Vyvanse abuse issues. They also may be more likely to use Vyvanse in larger amounts sooner than would someone without any predisposition for addiction. In this way, genetics could impact someone’s experience with Vyvanse withdrawal, but again, this is a very indirect influence.
The main ingredient of Vyvanse is lisdexamfetamine, and while it is not psychoactive itself, once it enters the blood it breaks down in the amino acid L-lysine and the stimulant drug dextroamphetamine. This is a form of the drug amphetamine that is structurally related to methamphetamine and is also a component of the medication Adderall. When combined with L-lysine in Vyvanse, dextroamphetamine is absorbed more slowly than it would be on its own, and this formulation was created in an attempt to reduce or abolish the abuse potential of Vyvanse. It did not work. While dextroamphetamine is absorbed more slowly, if taken in large amounts Vyvanse can still produce euphoria. Additionally, due to slower metabolism in the presence of L-lysine, Vyvanse can have a longer duration of action than if someone had taken an equivalent dose of dextroamphetamine on its own.
The way dextroamphetamine works is to increase the levels of the two major neurotransmitters dopamine and norepinephrine. Dopamine is a major excitatory neurotransmitter that has many roles, including producing feelings of pleasure, reward, and in high levels associated with Vyvanse use, euphoria. Norepinephrine is both a neurotransmitter in the brain and a hormone in the blood. In the brain, it can promote focus and concentration while in the blood it increases heart rate, blood pressure, and blood sugar levels. Vyvanse’s strongest and most profound effect is on dopamine by which it increases dopamine release, prevents dopamine reuptake, and also produces reverse transport of dopamine. Through this three-pronged mechanism, it can greatly increase dopamine levels in the brain, producing strong excitatory stimulation. The effect of norepinephrine is still strong, but in this case, Vyvanse only inhibits reuptake.
Through prolonged Vyvanse use and the chronically elevated levels of these two neurotransmitters, the brain will undergo changes to maintain balance and prevent damage. The first change to begin is known as downregulation and is the act of turning down the sensitivity of neurotransmitter receptors. Since dopamine experiences greater increases than norepinephrine, dopamine receptors will become downregulated further than norepinephrine receptors, but the both undergo downregulation of varying degrees. Another further change is neurological remodeling. This may begin anytime after downregulation has begun, and is the brain’s attempt to make structural changes so that it may better operate in a dopamine and norepinephrine downregulated environment. Once downregulation begins, someone will begin to experience Vyvanse withdrawal symptoms if they go too long without using the drug.
The symptoms of Vyvanse withdrawal, while almost never dangerous in a direct manner, are usually very uncomfortable. Additionally, the profound depression that can accompany withdrawal does pose increased risks of suicide or self-harm. Due to these issues as well as the risk of relapse it is highly recommended that if someone is expecting to undergo withdrawal, they should do so in a Vyvanse detox center. These facilities can provide medications, medical monitoring, and therapies to not only reduce the discomfort but they may also reduce the risks of dangerous outcomes. More than that, these centers can provide connections and referrals to continuing care after detox has been completed. This can help give someone the tools they need to build a solid foundation in recovery.
Vyvanse Detox CentersThere are several other stimulant drugs that can produce uncomfortable or even dangerous withdrawal symptoms. We have more in-depth withdrawal guides for drugs such as:
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