Vyvanse (lisdexamfetamine) is a central nervous system stimulant prescribed to treat attention-deficit/hyperactivity disorder (ADHD) and moderate-to-severe binge eating disorder (BED). The drug is an inactive prodrug converted in the body to its active form, dextroamphetamine. This active metabolite increases the levels of the neurotransmitters dopamine and norepinephrine in the brain, which regulate attention, impulse control, and alertness. Prolonged use, even as prescribed, can cause the brain to develop a physical dependence on these elevated neurotransmitter levels. When the medication is abruptly stopped or significantly reduced, the brain functions without the expected chemical support, leading to withdrawal.
Physical Manifestations of Withdrawal
The most profound physical symptom during Vyvanse withdrawal is overwhelming fatigue. This extreme tiredness, often described as a “crash,” can begin within 24 to 36 hours after the last dose. Individuals frequently experience hypersomnia, an excessive need for sleep that involves sleeping for extended periods or struggling to stay awake during the day.
The body’s metabolism and appetite are also affected by the absence of the stimulant. Since Vyvanse suppresses appetite, its discontinuation often results in a significant increase in hunger and food intake. This heightened appetite can lead to rapid weight gain in the initial phase of withdrawal.
Headaches are common as the body readjusts its chemistry. Some people report general body aches, muscle pains, and flu-like symptoms, contributing to overall physical discomfort. Nausea and stomach upset, such as diarrhea, can also occur during the acute withdrawal phase.
Psychological and Emotional Effects
The psychological fallout of Vyvanse withdrawal is often the most challenging and persistent aspect of discontinuation. A deep sense of dysphoria is common, frequently manifesting as a severe depressive episode. This mood disturbance can include profound sadness, irritability, and extreme mood swings.
The brain’s sudden lack of dopamine stimulation can trigger anhedonia, an inability to feel pleasure from enjoyable activities. This emotional flatness, combined with poor concentration and difficulty thinking clearly (brain fog), makes daily functioning difficult. Anxiety and restlessness are also frequently reported.
The potential for suicidal ideation can occur as a result of intense depression and dysphoria. Any expression of self-harm or suicidal thoughts requires immediate emergency medical attention. Psychological symptoms can be highly distressing and are sometimes more enduring than physical manifestations of withdrawal.
The Typical Withdrawal Timeline
The onset of Vyvanse withdrawal symptoms typically begins within 12 to 36 hours after the final dose is metabolized. The initial phase often presents with fatigue, mood changes, and cravings as the body recognizes the drug’s absence. Symptoms generally reach peak intensity between days two and four.
During this peak period, severe fatigue, depression, and anxiety are at their maximum. The acute phase usually lasts five to seven days, with many physical symptoms subsiding within the first one to two weeks.
However, some psychological symptoms, such as anhedonia, depression, and low energy, can linger for weeks or even months. This extended period is referred to as Post-Acute Withdrawal Syndrome (PAWS).
Safe Strategies for Discontinuation
Discontinuing Vyvanse should always be done under the supervision of a healthcare professional. Abruptly stopping the medication (“cold turkey”) is discouraged, as it can trigger a sudden, severe onset of withdrawal symptoms. The safest and most effective method is a gradual tapering schedule.
A medically supervised taper involves slowly reducing the daily dosage over several weeks or months. This allows the brain and body time to adjust to lower levels of stimulation. Physicians may suggest reducing the current dose by 10 to 20% every one to two weeks to minimize withdrawal intensity.
If psychological symptoms become overwhelming, especially intense depression, severe anxiety, or thoughts of self-harm, seek emergency medical help immediately. Ongoing therapy and counseling are recommended to manage emotional challenges and prevent relapse. Adhering to a plan developed with a healthcare provider ensures the safest transition away from the medication.