Vyvanse Side Effects: What to Expect and When to Call Your Doctor

Every medication has potential side effects, and Vyvanse (lisdexamfetamine dimesylate) is no exception. Knowing what to expect can help you manage your treatment and recognize when something needs medical attention. Most people tolerate Vyvanse well, but it's important to be informed.

What Is Vyvanse?

Vyvanse is a prescription stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) in patients ages 6 and older and binge eating disorder (BED) in adults. It contains lisdexamfetamine dimesylate, a prodrug that is converted to dextroamphetamine in the body. For a complete overview, see our guide on what Vyvanse is and how it's used.

Common Side Effects of Vyvanse

The following side effects are the most frequently reported in clinical trials. Most are mild to moderate and often improve within the first few weeks of treatment as your body adjusts:

• Decreased appetite (27–39%): The most commonly reported side effect. It's more pronounced early in treatment and may lead to weight loss. Taking Vyvanse with breakfast and eating regular meals can help.
• Insomnia or trouble sleeping (13–27%): Because Vyvanse is a stimulant that lasts up to 14 hours, taking it too late in the day can interfere with sleep. Take Vyvanse first thing in the morning.
• Dry mouth (4–26%): Staying hydrated throughout the day can help manage this.
• Irritability (10%): May be more common in children and adolescents. Usually mild and may improve over time.
• Nausea (6–8%): Taking Vyvanse with food can reduce stomach discomfort.
• Anxiety (6%): Some patients experience increased anxiety, particularly in the first weeks. Talk to your doctor if this persists.
• Dizziness (5%): Usually mild. Avoid driving or operating machinery if you feel dizzy.
• Upper abdominal pain (5–12%): More common in pediatric patients. Taking the medication with food may help.
• Headache: Commonly reported, typically mild and manageable with over-the-counter pain relievers.
• Weight loss: Related to decreased appetite. Your doctor should monitor your weight regularly, especially in children.

Serious Side Effects of Vyvanse

While less common, the following side effects require prompt medical attention:

Boxed Warning: Abuse and Dependence

Vyvanse is a Schedule II controlled substance with a high potential for abuse and dependence. Amphetamines, including lisdexamfetamine, can lead to drug dependence with prolonged use. Misuse of amphetamines may cause sudden death and serious cardiovascular events. Take Vyvanse only as prescribed, and never share your medication.

Cardiovascular Effects

Seek medical attention immediately if you experience:

• Chest pain
• Shortness of breath
• Rapid or irregular heartbeat
• Fainting

Vyvanse can increase heart rate and blood pressure. Patients with pre-existing heart conditions, structural cardiac abnormalities, or serious heart rhythm problems should not take Vyvanse. Your doctor should check your heart rate and blood pressure regularly.

Psychiatric Effects

Contact your doctor if you experience:

• New or worsening anxiety, agitation, or panic attacks
• New psychotic symptoms (hearing voices, paranoia, mania)
• New or worsening aggressive or hostile behavior
• Suicidal thoughts

Stimulant medications can exacerbate psychiatric conditions. Patients with a history of psychosis, bipolar disorder, or depression should be monitored closely.

Serotonin Syndrome

If you take Vyvanse with certain other medications (particularly SSRIs, SNRIs, or triptans), you may be at risk for serotonin syndrome—a potentially life-threatening condition. Symptoms include agitation, hallucinations, rapid heartbeat, fever, muscle rigidity, and loss of coordination. Seek emergency medical attention immediately if you experience these symptoms.

Peripheral Vasculopathy (Raynaud's Phenomenon)

Stimulants, including Vyvanse, can cause blood vessel constriction in the fingers and toes. Symptoms include numbness, cool skin, color changes, or pain. Tell your doctor if you notice these symptoms.

Side Effects in Specific Populations

• Children and adolescents: Growth suppression (height and weight) has been reported with long-term stimulant use. Your child's doctor should monitor growth regularly and may consider treatment breaks if growth is affected.
• Pregnant or breastfeeding: Vyvanse should be used during pregnancy only if the potential benefit justifies the risk. Amphetamines are excreted in breast milk. Discuss the risks and benefits with your doctor.
• Elderly: Clinical studies of Vyvanse did not include enough patients over age 65 to determine safety differences. Start with the lowest effective dose.

How to Manage Vyvanse Side Effects

• Take Vyvanse in the morning to minimize insomnia.
• Take it with breakfast to reduce nausea and stomach discomfort.
• Stay hydrated to manage dry mouth.
• Eat regular meals and snacks even if your appetite is reduced.
• Monitor your heart rate and blood pressure at home if your doctor recommends it.
• Don't stop abruptly without talking to your doctor—discuss a tapering plan if you want to discontinue.
• Keep all follow-up appointments so your doctor can monitor for side effects and adjust your dose if needed.

Final Thoughts

Most people tolerate Vyvanse well, and many common side effects improve within the first few weeks. The key is knowing what's normal, what's not, and when to call your doctor. Always take Vyvanse exactly as prescribed and report any concerning symptoms promptly.

For more about how Vyvanse works in your body, see our mechanism of action guide. To learn about potential drug interactions, read our Vyvanse drug interactions guide. And if you're having trouble finding Vyvanse at your pharmacy, Medfinder can help you locate a pharmacy with it in stock.