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Vyvanse Withdrawal & Detox Guide

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Phillippe Greenough

Article Updated: 09/25/2020

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 be psychologically painful and fairly long-lasting. 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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Vyvanse Pharmacology & Addiction

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. 1, 2, 3, 4, 5, 6

Symptoms of Vyvanse Withdrawal

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.

Some of the symptoms of Vyvanse withdrawal include:

  • Depression and Dysphoria (with or without suicidal ideation)
  • Anxiety
  • Increased Irritability or Aggression
  • Anhedonia (a reduced ability to experience pleasure)
  • Cravings for Vyvanse
  • Hypersomnia, then Insomnia
  • Vivid Dreams or Nightmares
  • Intense Restlessness
  • Clouded or Disorganized Thinking
  • Increased Appetite
  • Fatigue and Lethargy
  • Psychosis (due to Vyvanse use, not withdrawal, this may rarely persist into withdrawal)

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. 7, 8, 9

Vyvanse Withdrawal Timeline

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. 10

A common timeline for the crash, withdrawal, and extinction of Vyvanse withdrawal symptoms may look like:

First Week

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 withdrawal proper. The cravings, anxiety, depression, and fatigue levels will still be present but may improve slightly. Irritability may increase around this time as well.

Second Week

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.

Third Week

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 so so again, although it is usually minor.

Fourth Week and Onwards

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 a life without Vyvanse.

The Importance of Vyvanse Detox

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 Centers

Physical Effects of Vyvanse Withdrawal

Vyvanse, along with many other stimulants, produces no direct physical effects during withdrawal. The psychological effects, however, can lead to serious neurological instabilities and out of character behaviors which may, in turn, produce negative physical outcomes. These complications are not common, but they do occur.

Risk of Suicide

Depression is a very common effect of Vyvanse withdrawal as we will discuss later. As it relates to physical effects, the depression experienced during withdrawal can sometimes reach quite severe levels. As the brain is depleted of dopamine, along with dopamine downregulation, it is not uncommon for someone to have difficulty finding a reason to live. In the most serious cases, this can lead to thoughts of suicide and suicide attempts. While not exactly common, people do kill themselves to escape the psychological discomfort and despair that can accompany Vyvanse withdrawal, and this is by far the most serious effect of Vyvanse withdrawal.

Psychological Effects of Vyvanse Withdrawal

There are multiple psychological effects of Vyvanse withdrawal, and some are more common than others. The downregulation and further remodeling that occurs in response to chronic Vyvanse use can result in severe short-term symptoms and much longer-lasting, although less severe, post-acute symptoms. The disruptions to both dopamine and norepinephrine systems will take time to recover, and the time while this recovery is being performed can be a mentally painful time.

Depression

Possibly the most common and possibly severe effect of Vyvanse withdrawal, depression can even present real physical dangers, as mentioned above. Depression can have two main causes during withdrawal, both neurological and behavioral, although it is often a combination of these two that results in a depressed mental state.

From a neurological standpoint, this has to do with dopamine downregulation in the short term, and the more protracted symptoms are due to neurological remodeling to dopamine systems that occur after downregulation has begun. Dopamine, a major excitatory neurotransmitter responsible for feelings of reward and pleasure, can be depleted in the days immediately after someone stops using Vyvanse. Coupled with downregulation to dopamine receptors, this can produce a severe deficit in a person’s ability to feel good in any way. This is the cause of the often profound depression felt during the crash phase. The longer-lasting depressive symptoms have to do with the changes made to dopamine pathways in the limbic system, aka the “reward center” of the brain, and this can take quite some time to revert to pre-Vyvanse levels of function. In short, the reduced ability of dopamine to produce positive feelings can result in a bleak and cold view of the world that may seem like it will never change. Aside from these direct effects, there may be secondary effects on the neurotransmitter serotonin, a major mood-altering neurotransmitter that is known to be related to depressive symptoms and other mood disorders.

As far as behavioral causes are concerned, Vyvanse use can often become a very powerful, but unhealthy, coping mechanism that people will use to cope with the usual stresses of life. Through continued use, this becomes a more integral component of someone’s overall coping strategy with life and they may rely on Vyvanse more and more for comfort as time passes. Finally, and usually due to problems caused by Vyvanse addiction, this coping skill will be the only thing that is physiologically able to bring someone any sense of security or comfort. When this is suddenly removed and withdrawal has begun, it is not uncommon for someone to feel scared, helpless, and hopeless. Without the strong coping mechanism they have relied on for months or years to bring relief, it is not uncommon for someone to experience profound despair and depression. 11, 12, 13

Cravings for Vyvanse

Cravings are another very common and long-lasting effect of Vyvanse withdrawal. This is also caused by neurological changes due to Vyvanse addiction, similar to depression. Dopamine has a critical role in the limbic system, which is normally used for behavioral reinforcement for essential biological functions like eating, sex, and social interactions. Vyvanse use can create surges of dopamine in the limbic system that are much stronger than those produced naturally. When dopamine systems are disrupted to the degree they are through Vyvanse use, someone will have a greatly reduced ability, or even a total inability, to experience pleasure for a while after they stop using the drug. This results in someone beginning to associate any thoughts of pleasure with Vyvanse use, and during withdrawal when someone wants relief from the strong negative psychological symptoms, they will naturally crave Vyvsasne use for the strong pleasure and sense of ease it can produce. 13

Anxiety

Another fairly common effect of Vyvanse withdrawal, anxiety can be quite disruptive to someone’s chances of long-term recovery. Anxiety, especially combined with depression, can promote isolationist tendencies and make it difficult for someone to connect with others and reach out for help. Symptoms of anxiety can often have both neurological and behavioral causes. Aside from the direct effects that Vyvanse produces in dopamine and norepinephrine systems, chronic use can also cause secondary, downstream changes in serotonin systems as well. Serotonin is a major mood regulator and stabilizer, and disruptions in this system can result in increased anxiety. While the way this works is not fully understood, it is thought that chronic Vyvanse use can increase the expression of the serotonin transporter protein, which essentially recycles serotonin. The changes produced through chronic amphetamine use seem to increase the activity of this transporter, causing it to sweep up serotonin sooner than it normally would, resulting in less serotonin signaling.

From a behavioral perspective, the cause is very similar to the behavioral causes of depression during Vyvanse withdrawal. The use of Vyvanse as a powerful coping mechanism can become an emotional crutch. When this is suddenly removed and someone loses their primary means of coping with the stresses of life, the helplessness can encourage a sense of fear and vulnerability. Until someone can develop newer, healthy coping skills these symptoms of anxiety may persist at fairly high levels. 12, 13, 14

What Factors Influence the Intensity of Vyvanse Withdrawal?

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:

  • The amount of Vyvanse someone regularly used
  • The length of time someone used Vyvanse
  • Co-occurring mental health issues
  • A genetic predisposition to addiction

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.

Vyvanse Withdrawal Treatments

Withdrawal from Vyvanse can be a very unpleasant experience but luckily, there are treatment options available to reduce the risks and discomfort. These treatments come in the form of medications and behavioral therapy with each approach providing unique benefits. These may be most effective when used in conjunction, as they can act synergistically to produce more effective results than either would on their own. 15

Medications

While there are currently no FDA approved medications to treat amphetamine withdrawal, there are medications that can be used to treat individual symptoms of Vyvanse withdrawal as they arise. Some of these may be used in the short-term while others can safely be used for extended periods.

Some of the classes of medications that are commonly used to treat Vyvanse withdrawal symptoms include:

  • Antipsychotics (in the rare event of amphetamine-induced psychosis persisting into withdrawal)
  • Antidepressants (either tetracyclic, tricyclic, SSRI, or SNRI)
  • Anti-Anxiety Medications (such as benzodiazepines or buspirone, depending on the circumstances)
  • Sleep Aids
  • Anticonvulsants
  • Dopamine Agents
  • GABA/Glutamate Agents
  • Anticonvulsants
  • Opioid Antagonists (they may help with cravings)

These are just some broad categories of commonly used medications, and some of these classes have many specific medication options. Everyone responds to certain medications in their own way; with some options being more effective for some people. Getting the help and guidance from the trained medical professionals at a Vyvanse detox center can be invaluable, as they are experienced in helping people find the right medications quickly. Aside from this, they may also provide medical monitoring and supervision during the most difficult “crash” phase of Vyvanse withdrawal and reduce the risk of negative outcomes.

Therapies

Therapeutic approaches to Vyvanse withdrawal treatment have proven quite effective, especially when combined with medication. These therapies can help during the often rough, early days of detox, but their real benefits often become apparent after spending some time regularly utilizing therapy. Dealing with the stresses of withdrawal is one benefit, and they may also allow someone to deal with any underlying issues they may have, such as trauma suffered during active Vyvanse use. Therapy can not only help someone to feel better during withdrawal, but it may also increase their chances of successful, long-term recovery.

Some of the therapeutic techniques commonly used to treat Vyvanse withdrawal symptoms include:

  • Individual Counseling
  • Group Therapy
  • Behavioral Therapy
  • Relapse Prevention Skills
  • Coping Skills Development
  • Aftercare Planning

These therapeutic approaches are just a few of the many options that can be effective. Similar to medications, everyone is going to find different therapies more or less effective, so it may take some tries to find the best one. This is another case where entering a Vyvanse detox center can be very beneficial. Having professional clinicians and psychologists to advise and guide someone through the issues they would like to address and the best therapies for those issues can help someone find the right option(s) as quickly as possible.

Making it through Vyvanse withdrawal may seem like an impossible challenge, but it can be done. With the help provided at Vyvanse detox centers, having professional guidance, care, and support can make the journey possible. The benefits of these centers don’t end at the end of someone’s stay either. These facilities have connections with their local recovery communities and can offer referrals and help advise someone on continuing treatment after detox has been completed. Once detox is completed, there is still work to be done. Long-term recovery is possible, and it often starts when someone reaches out and asks for help.

References For This Article

  1. 1 FDA AccessData: Vyvanse (lisdexamfetamine dimesylate) Capsules Label
  2. 2 Pharmacy & Therapeutics: Lisdexamfetamine Dimesylate (Vyvanse), A Prodrug Stimulant for Attention-Deficit/Hyperactivity Disorder
  3. 3 Frontiers in Pharmacology: Pharmacokinetics and Pharmacodynamics of Lisdexamfetamine Compared with d-Amphetamine in Healthy Subjects
  4. 4 Clinical Drug Investigation: Lisdexamfetamine Dimesylate - Prodrug Delivery, Amphetamine Exposure, and Duration of Efficacy
  5. 5 Journal of Psychopharmacology: Human Pharmacology of Intravenous Lisdexamfetamine Dimesylate - Abuse Liability in Adult Stimulant Abusers
  6. 6 The Journal of Neuroscience: Amphetamine Mechanisms and Actions at the Dopamine Terminal Revisited
  7. 7 Center for Innovation to Implementation: Treatment of Acute Intoxication and Withdrawal from Drugs of Abuse
  8. 8 WHO Expert Committee on Drug Dependence: Lisdexamfetamine
  9. 9 Australian Government Department of Health: The Amphetamine Withdrawal Syndrome
  10. 10 Brain Communications: Dependence, Withdrawal, and Rebound of CNS Drugs - An Update and Regulatory Considerations for New Drugs Development
  11. 11 Neuropsychopharmacology: Behavioral and Neurobiological Mechanisms of Punishment - Implications for Psychiatric Disorders
  12. 12 Journal of Experimental Neuroscience: Amphetamine Withdrawal Differentially Increases the Expression of Organic Cation Transporter 3 and Serotonin Transporter in Limbic Brain Regions
  13. 13 Neuropharmacology: Withdrawal from Chronic Amphetamine Produces Persistent Anxiety-like Behavior but Temporally-Limited Reductions in Monoamines and Neurogenesis in the Adult Rat Dentate Gyrus
  14. 14 Frontiers in Molecular Neuroscience: Wired for Behaviors - From Development to Function of Innate Limbic System Circuitry
  15. 15 Cochrane Database of Systematic Reviews: Treatment for Amphetamine Withdrawal
  16. 16 StatPearls: Dextroamphetamine-Amphetamine
  17. 17 StatPearls: Amphetamine

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