Taken once and lasting for 12 hours. Whether you’re six years old or 65.

Sounds like this might be a good idea for a new medication. Well, Ortho-MacNeil thought so. And the result is CONCERTA, a new timed-release drug for not only adults with ADHD, but children as well.

Recently approved by the US Food and Drug Administration, for adults, this medication has been on the market (as you probably well know) for children for quite a while. In fact, it was the first of the new generation of time-released drugs for ADHD.

CONCERTA uses a relative new delivery system, called OROS – which stands for Osmotic Release Oral System — to help deliver “poorly soluble drugs” to your body as quickly as possible. Additionally, this method unique to CONCERTA gives your system a consistent dosage of the medication over 12 hours. This is good news not only to get the symptoms alleviated fast, but to avoid those ups and downs that often accompany other medications.

Whether you choose this medication is a decision between you and your doctor. I’m certainly not saying it’s the right medication for you. Now, you know it’s approved for adults.

It’s important to realize something that many people don’t: That ADHD does not simply disappear for many individuals when they reach that magical, legal age of 18. In fact, research shows that up to 70 percent of children are still affected with ADHD once they hit adulthood!

Statistics show that adult ADHD affects some 8 million people – or one in 20 of us! – on a daily basis. Those who do have it know exactly what I’m talking about – even if your co-workers or supervisors don’t. For adults, ADHD may get in the way of not only career development, but social relationships as well as personal relationships.

Public health officials generally label a mental health condition a “disorder” and recommend treatment when the symptoms impair your daily life patterns. The fact that you now have the option at least to have your symptoms lessened for a full 12 hours is not necessarily a bad thing!

Options are usually quite desirable!

What is the impact of CONCERTA being approved for Adults?

My experience is that most Psychiatrists who are experts in ADHD were already using this medication for Adult ADHD. However, having this approval (or ‘indication’) for adult ADHD means that more physicians will feel comfortable to use it in adults when it is indicated. This may mean that it will be easier for adults to get the medication that they need.

At this time, the following medications are indicated for Adult ADHD:

* Concerta

* Strattera

* Vyvanse

* Adderall XR

* Biphentin (Canada).

There may be some other medicines approved for adults in the USA. As I’m a Canadian doctor, I’m not sure if there are others. Please share your comments or thoughts below.

Dr. Kenny

Technorati Tags: Concerta, ADD, ADHD, Medication, Adult ADHD

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Vyvanse is the newest medication to come out for ADD and ADHD in the USA. I have posted articles on Vyvanse, and many of my readers have shared their experiences with Vyvanse (over 50 comments) about whether Vyvanse works.

As a Canadian Doctor, I am not in a position to prescribe this medicine for my patients, because it is not in Canada yet. In fact, I am not aware that it is in any other country than in the USA.

One blog reader asked: ‘When can we expect to get Vyvanse in Canada?’

The short answer to this is: I don’t know.

I can tell you that at the earliest it will be well into 2008, and possibly 2009.

I will continue to update this blog as I find out more information. To keep up to date with this information, just enter your name and email address in the top right hand corner to receive email updates.

Dr. Kenny Handelman

Technorati Tags: Vyvanse, ADD, ADHD, Canada

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Vyvanse is the newest medicine to come to the US for the treatment of ADHD and ADD. I have asked you (the readers of this blog) about your experiences with it, and there has been a lot of discussion (see the comments section on ‘Does Vyvanse Work?‘).

There have also been a lot of questions. One question which has come up again and again is: ‘Can Vyvanse be used for Adult ADD?’

Read on for the answer…

At the time this article is written, Vyvanse has been approved by the FDA for use in ADHD in children aged 6-12 years old. Shire (the company that manufactures and sells Vyvanse) has applied for approval for Vyvanse to be used to treat adults with ADHD.

Even though the FDA has not yet approved Vyvanse for the treatment of Adult ADD/ADHD, doctors can still prescribe it, if they think that it is the right medicine for you.

How can that be?

There is something called ‘off label usage’. What that means is that even though Vyvanse is not officially approved for anyone with ADD or ADHD over 12 years old, doctors can still prescribe it if they feel that it is the right treatment. Technically, a doctor could prescribe it for any situation in which he/she thought that it would be the best treatment, however the doctor would have to be sure that it was medically relevant, and wouldn’t be malpractice. Examples: Vyvanse for ADHD at the ages of 13, or 23, or 33 is logical and will most likely help, however Vyvanse for a face rash is illogical and would likely be malpractice.

I suspect that Vyvanse will be used extensively in teens and adults with ADD or ADHD, because one of its main advantages is that it cannot be abused, and these are the ages when this can be a concern. Soon, the FDA will most likely approve Vyvanse for teen and adult ADHD, and then it will be official. (How long will that take? One can never know until it is approved. I would expect anywhere from 1 year to 2 years maximum. Hopefully less…).

In the mean time, if you are an adult with ADD or ADHD, and think that vyvanse may be the best medicine for you, go ahead and talk to your doctor about it. He or she may agree.

Dr. Kenny

Technorati Tags: ADD, ADHD, Vyvanse, Vyvanse for Adult ADD, Vyvanse for Adult ADHD

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Vyvanse is the newest medicine for ADD or ADHD in the USA. I have written several articles on this blog on Vyvanse, and have had great feedback and comments from readers of this blog. For example - if you want to find out if vyvanse works, visit this post to read many people’s first hand experiences.

One question which many people ask is about the dosing of Vyvanse.

This article will provide you with the answers you need to get the right dosage of Vyvanse.

Research studies compared the dosing of Vyvanse with Adderall XR. What this research showed was the following:

• Vyvanse 30 mg = Adderall XR 10 mg
• Vyvanse 50 mg = Adderall XR 20 mg
• Vyvanse 70 mg = Adderall XR 30 mg

The recommendations for the starting doses of Vyvanse are as follows: Doctors should start Vyvanse at 30 mg, and then gradually increase the dose to 50 mg, and then up to 70 mg if needed. Of course the doctor would monitor response to the medicine (i.e. if there is a great response and ADHD is controlled at 50 mg, then there is no need for 70 mg of Vyvanse). The doctor will also monitor for side effects - i.e. if there are too many side effects at 70 mg, then the dose may need to be dropped to 50 mg of Vyvanse.

The importance of the ‘conversion’ dosing listed above relates to those people who may switch from one stimulant medicine to Vyvanse. Using the information above, you can figure out how to change your dose of Adderall XR to Vyvanse.

If you are switching from Concerta to Vyvanse, then you will need to follow these rough guidelines (and of course, talk to your doctor - who can personalize the information to suit your treatment):

• Concerta 36 mg = approx. Vyvanse 30 mg
• Concerta 72 mg = approx. Vyvanse 50 mg

I have to say that the dose changes from Concerta to Vyvanse are based on logic, and not on research.

Here is the logic:

1. Concerta 36 mg works out to approx. 8 mg of regular ritalin three times daily.
2. That is approximately 5 mg of regular adderall twice daily.
3. That works out to approximately Adderall XR 10 mg once daily.
4. Since Adderall XR 10 mg daily is equal to Vyvanse 30 mg, once can guess that Concerta 36 is equal to approximately Vyvanse 30 mg.

[Click here for a full review of how to calculate concerta doses.]

There are two important points to remember here:

1. Even though I can suggest what the equal doses are, you may react differently to any one medicine. Only testing, monitoring and talking to your doctor will help to sort out what the right dose is for you.
2. Please talk to your doctor about your individual care. Even though this blog article may help you to find the right dose of Vyvanse based on a combination of my review of the research and my opinion, your doctor is an expert in your care.

Thank you for reading, and please post any comments or your experiences with the dosing of Vyvanse in the comments below.

Dr. Kenny

Technorati Tags: Vyvanse, Vyvanse dose, Concerta, Adderall, Adderall XR, ADHD, ADD, ADHD Medication

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Vyvanse is the newest medicine for ADD and ADHD. It uses an innovative approach so that it is an ADHD ADD medication that cannot be abused.

As a Canadian doctor, I am not able to prescribe Vyvanse, because it is not yet available outside of the US.

So, my biggest question is: Does Vyvanse work?

I have read the research, I have heard the presentations, but I don’t have real life experience with this medicine.

This is where you can help me out.

I want to hear from anyone who has tried Vyvanse, or even considered trying Vyvanse.

Just go ahead and enter a comment below.

Please realize that when you click submit, it will take a little bit of time until your comment reaches my blog. That is because every comment is moderated (i.e. I want to make sure that there are no spam comments, and nothing hateful, racist, etc.).

I found this video - where someone shares his or her experience with Vyvanse - and you can watch it here:

Now, it’s your turn. Please type in any of your own personal experiences with Vyvanse so that the readers of this blog can benefit from your knowledge and experience. I know that the readers of this blog span the whole globe - so if you have experience with Vyvanse, all of the readers of this blog (American, Canadian and International) will appreciate your contribution very much!

Thank you for your help,

Dr. Kenny

Technorati Tags: Vyvanse, ADD, ADHD, Medication for ADHD, Adult ADHD, Adult ADD, ADHD Video, Vyvanse Video

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Shire Pharmaceuticals has announced that its new ADD ADHD Medication, Vyvanse is now available in pharmacies across the US.

Vyvanse, also known as lisdexamfetamine dimesylate, is the newest addition of medications available to treat the common Attention Deficit Hyperactivity Disorder (or Attention Deficit Disorder).

Vyvanse is a ‘pro-drug’, which means that it is inactive unless it is swallowed, and it goes through metabolism in the liver. This means that vyvanse cannot be abused, and there is no addiction with Vyvanse.

Vyvanse is similar in action to Adderall, and works for up to 12 hours. The capsule can be opened and sprinkled for children who cannot swallow pills.

Currently, vyvanse is approved for children aged 6-12 with ADD or ADHD. Shire has also applied to the FDA for approval for use in adults with ADD or ADHD.

Is Vyvanse right for you or your child?

The best thing to do is to speak to your doctor - because it is available now across the US.

In my ADD/ADHD Membership site, I taught an in depth lesson of how Vyvanse works in the body. To learn more, visit: ADHD M.O.R.E. (Member’s Online Resources and Education).

Technorati Tags: Vyvanse, ADHD Medication, ADD Medication, Vyvanse Addiction, Vyvanse Abuse

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Although many people worry about ADD/ADHD medication leading to addiction in children and teens who take it – there is solid research now that shows that when children and teens take ADD/ADHD medication as prescribed, there is a significant reduction in the long term risk of drug and alcohol problems (it is reduced by almost 75%).

However, there are still people who abuse ADD/ADHD medications. In the Toronto area, regular ritalin pills (i.e. 10 mg tablets) can be bought on the street for approximately $5. Why? Because people will crush them and snort them to get high.

The newer and long acting ADD/ADHD medications – including Concerta, Adderall XR, Biphentin, Metadate CD, Ritalin LA, Focalin XR – are much harder to abuse because of their long acting nature. However, in theory, a creative drug abuser could figure out a way to extract the active ingredient and get high, by snorting it or injecting it.

What’s the difference with Vyvanse?

Because Vyvanse is a ‘pro-drug’, it cannot be abused.

A pro-drug means that the active medicine is bound to a protein, so it doesn’t work as an amphetamine when it is first taken. It only starts to work after it is swallowed and goes through the liver (the first step a medicine takes when leaving the stomach). When it goes through the liver, the liver cuts off the protein, and then it becomes an active medicine.

If Vyvanse is taken any other way – snorted, injected, or any other way in an attempt to get high, it will just be inert – i.e. it won’t work at all.

The only way Vyvanse is active – is if it is swallowed and then passes through the liver.

Vyvanse is the first stimulant medicine made available with zero potential for abuse.

When it comes to the other medications with low abuse potential – these include the long acting stimulants – including: Concerta, Adderall XR, Biphentin, Metadate CD, Ritalin LA, Focalin XR, etc.

When it comes to the only other medication with zero potential for abuse, that is the non-stimulant for ADD/ADHD, Strattera. This is also a good option, however if someone needs a stimulant medicine with no potential for abuse, Vyvanse is the medication to choose.

Technorati Tags: Vyvanse, ADHD, ADD, Attention Deficit Hyperactivity Disorder, Addiction, Strattera, Adderall XR, ADHD Medication, ADD Medication

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What is Vyvanse?

Vyvanse is a new ADD/ADHD drug manufactured by Shire that was approved by the FDA in February 2007 to treat ADD/ADHD symptoms in children aged 6 through 12. It is a prodrug, which means that it must be orally ingested to activate its main ingredient, lisdexamfetamine dimesylate (the same active ingredient in Adderall). Once it passes through the liver, a protein chain is taken off the medication and it becomes an active amphetamine. Therefore, the abuse potential for Vyvanse is much lower than most ADD/ADHD drugs.

In clinical studies, parents reported that their children’s ADD/ADHD symptoms were consistently controlled throughout the day, even through homework time from 4 P.M. to 6 P.M. Additionally, children taking Vyvanse in the study were able to focus and perform better on tests; in a timed math test, a group taking Vyvanse attempted 51% more math problems than the group given placebo, and provided correct answers 54% more often than the placebo group.

An overall improvement was recorded in 95% of children that took Vyvanse for 12 months.

What are the characteristics of Vyvanse?

Vyvanse is similar to Adderall; its active ingredient is lisdexamfetamine dimesylate. It provides consistent ADD/ADHD symptom control for up to 12 hours. Vyvanse is a capsule that can be swallowed whole or broken up and mixed with water, ice cream, applesauce, or yogurt (for kids who can’t swallow).

Vyvanse is taken once daily and is available in three dosage strengths:

• 30 mg—white and orange capsule

• 50 mg—white and blue capsule

• 70 mg—blue and orange capsule

Three different strengths give you and your doctor some flexibility in determining which dosage is right for your child. The recommended starting dose for Vyvanse is 30 mg once per day taken orally in the morning. The dosage may then be increased by up to 20 mg per day at weekly intervals, up to a maximum of 70 mg per day.

Who is Vyvanse approved for?

Currently, Vyvanse is approved for children aged 6 to 12 years.

On June 29, 2007, Shire announced that they have submitted a supplemental New Drug Application to the FDA for Vyvanse for the treatment of ADD/ADHD in adults. The application is subject to a 10-month review period.

What are the side effects of Vyvanse?

Vyvanse was very well tolerated in clinical studies with children. The most common side effects were decreased appetite, difficulty falling asleep, irritability, and stomachache. Generally, the side effects were described as mild to moderate; occurrence and severity of side effects decreased over time. As with any prescription medication, it is important to remember that your doctor has prescribed it because he/she feels that the benefits will outweigh the possibility of side effects.

How much does Vyvanse cost?

Vyvanse will cost the same as Shire’s other popular ADD/ADHD drug, Adderall XR: around $3.40 a day. The cost may even be less than Adderall XR because it is estimated that patients who switch from Adderall XR to Vyvanse might need fewer doses.

Ritalin remains the cheapest ADD/ADHD drug; Vyvanse costs considerably more than Ritalin and Ritalin SR. The cost is comparable to the 36mg and 54 mg doses of Concerta, which is around $140 per month

When can Vyvanse be used?

Vyvanse should be taken once daily in the morning. It provides consistent ADHD symptom control throughout the day for up to 12 hours. In clinical studies, parents reported that their children’s ADD/ADHD symptoms were controlled at approximately 10 A.M., 2 P.M., and 6 P.M., and demonstrated consistent symptom control throughout the day.

Vyvanse is a once-a-day capsule that should be taken in the morning, either with or without food as prescribed by your child’s doctor. If your child is unable or unwilling to swallow pills, Vyvanse capsules may be opened and the entire contents of the pill can be dissolved in water or sprinkled on applesauce, ice cream, or yogurt. The entire portion must be finished and should not be stored for later use.

Can Vyvanse be abused?

The abuse potential of Vyvanse is extremely low; the medication is designed to have a reduced or minimal abuse potential. Since Vyvanse requires oral ingestion to be converted to the active drug, the capsule contents are highly unlikely to be sought out for inhalation or injection. Vyvanse is a prodrug; it must pass through the liver where it is converted to an active amphetamine.

How does Vyvanse compare to Ritalin, Ritalin SR, and Concerta?

Vyvanse is a new class of ADD/ADHD medication. Unlike Ritalin, Vyvanse is not an immediate release stimulant. Vyvanse must pass through the liver before it is converted to an amphetamine, so the abuse and addiction potential is much lower. Ritalin SR and Concerta are long-acting formulas like Vyvanse, but Vyvanse has been shown to provide more consistent symptom control over a longer period of time than Ritalin SR and Concerta.

Ritalin, or methylphenidate, must be taken two or three times a day for symptom control, whereas Vyvanse is only taken once. The effectiveness of Ritalin is often inconsistent. It is inexpensive, but abuse and addiction potential is much higher with Ritalin than with Vyvanse.

Ritalin SR is a long-acting formulation of methylphenidate with inconsistent performance reviews. It doesn’t work for everyone and usually lasts up to 6 hours. However, like short acting Ritalin, Ritalin SR is inexpensive.

Of the three, Concerta is the most comparable ADD/ADHD medication to Vyvanse. They both control symptoms for up to 12 hours and are generally well-tolerated. Concerta is not a prodrug, so the abuse potential is higher than it is for Vyvanse.

Where is Vyvanse Available?

At the time of publication of this article, Vyvanse will be available soon in the USA. It is not yet available in other parts of the world. Please check back, as I will update this article when Vyvanse will be available in other countries such as: Canada, UK, Australia, Europe, etc.

The Bottom Line About Vyvanse

Treatment and management of ADD/ADHD requires many components; this article focuses only medication. Vyvanse is a breakthrough ADD/ADHD drug and many doctors and parents will seriously consider switching from their current ADD/ADHD medication for the benefits Vyvanse offers: low abuse and addiction potential, one daily dose, and symptom control for up to 12 hours. For more information on the other treatments of ADD/ADHD: 1) sign up for my ADD/ADHD newsletter at www.TheADHDDoctor.com, and 2) peruse this blog for more articles about ADD/ADHD.

Technorati Tags: Vyvanse, ADHD, ADD, Attention Deficit Hyperactivity Disorder, Addiction, Medication for ADHD, Medication for ADD, Adderall, Adderall XR

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