Vyvanse crash vs. withdrawal. Symptoms, safety, and more

Learn the difference between a Vyvanse crash and Vyvanse withdrawal and what to do to treat, and prevent, symptoms

By Daniel Cardin, Pharm.D. | Updated on May 2, 2024 Medically reviewed by Leslie Greenberg, MD

Key takeaways

Vyvanse is a brand-name drug approved by the FDA for the treatment of attention deficit hyperactivity disorder (ADHD) in adults and children and binge-eating disorder (BED) in adults.
Vyvanse is an amphetamine and central nervous system stimulant. It is designed to be long-acting due to its chemical properties and provides a sustained effect when taken as a capsule or chewable tablet.
Since ADHD medications are relatively common, you may have heard about a “Vyvanse crash.”
This article will explain all you need to know about common difficulties that patients might experience when taking Vyvanse and describe how to avoid some unnecessary side effects.

What is a Vyvanse crash?

A Vyvanse crash describes a constellation of symptoms that can occur when Vyvanse is not taken as prescribed, and the medication starts to wear off. Also known as Vyvanse “comedown,” this crash includes feelings of anxiety, irritability, tiredness, mood swings, and a return of ADHD symptoms (such as trouble concentrating). The active metabolite of Vyvanse stays in your system for about two to three days after a dose. However, more than half the dose will be out of your system after about 11 hours. Vyvanse is routinely taken in the morning to help with attention during daytime tasks. A crash or rebound effect usually occurs in the afternoon or evening when the drug levels are dwindling. It can also happen when a dose is missed. Crashes like this are not unique to Vyvanse—they occur with many prescription stimulant drugs such as Adderall, Ritalin, Focalin, etc. Crashes can occur in patients taking short-acting or long-acting stimulants for ADHD.

Related: What is Vyvanse?

Vyvanse crash vs. Vyvanse withdrawal

A Vyvanse crash is not the same as a Vyvanse withdrawal. While both are caused by low levels or absence of Vyvanse, they differ in their timing and symptoms. Withdrawal occurs when a patient stops taking Vyvanse, with symptoms developing around 36 hours after the last dose. A crash entails milder symptoms and is far more common. Crashes can occur despite consistent and proper use of Vyvanse. Crash symptoms are typically easier to manage than symptoms of withdrawal.

Vyvanse withdrawal symptoms

When a longtime user of Vyvanse suddenly stops taking their medication, they may experience:

Mood swings
Anxiety
Fatigue
Shakiness
Difficulty sleeping
Increased appetite
Excessive sleeping
Cravings for Vyvanse
Headaches
Anhedonia (decreased ability to feel pleasure)
Inability to focus and concentrate.

Further information on Vyvanse withdrawal symptoms can be found at withdrawal.net, a resource provided by the American Addiction Centers.

How to prevent a Vyvanse crash

People starting on Vyvanse may be more susceptible to a Vyvanse crash. A healthcare provider may need to adjust a patient’s medications before their ADHD medication is working optimally. Here are a few tips that can help patients avoid crashes in the meantime:

Take Vyvanse exactly as prescribed. Clarify any directions that are not clear with your doctor. Do not run out of pills. Do not discontinue this prescription without advice from your physician.
Take Vyvanse at the same time every morning. This helps ensure consistent levels of Vyvanse in your body while helping you remember to take your dose every morning.
Inform your doctor if you are experiencing crash symptoms. Your healthcare provider may adjust your dosage or change your ADHD medication
Tell your healthcare provider and pharmacist about all of your prescription medications. Certain medications may contribute to a Vyvanse crash, such as depressants. Examples include alcohol, muscle relaxants, marijuana, and sedatives. Additionally, medications that make urine more acidic have been shown to reduce the effectiveness of Vyvanse. Your provider may adjust the scheduling of your doses or change medications as appropriate to minimize drug interactions.
Avoid certain foods such as grapefruit juice, citrus fruits, and caffeinated drinks. Foods that make urine more acidic can reduce the effectiveness of Vyvanse. Caffeine can contribute to a Vyvanse crash by causing similar rebound symptoms such as fatigue or irritability and can contribute to sleeping difficulties. Caffeine can also worsen anxiety or shakiness caused by a Vyvanse crash.
Eat well and stay hydrated. It is easy for patients on Vyvanse to become so focused on tasks that they forget to eat and drink regularly. Eating three healthy meals and drinking water daily can minimize crash symptoms such as low energy, shakiness, irritability, or brain fog.

What happens if you stop taking Vyvanse?

Vyvanse withdrawal symptoms can occur in patients stopping Vyvanse abruptly. Symptoms are usually mild and can be minimized by gradually decreasing the stimulant dose before stopping therapy altogether. Patients on higher doses of Vyvanse (e.g., 70 mg) with a long duration of therapy are more likely to experience withdrawal symptoms if an appropriate wean is not performed.

Patients may want to discontinue Vyvanse for various reasons. They might want to avoid side effects of weight loss, dry mouth, or nausea intolerable or may simply desire to off of ADHD medications. However, weaning a patient’s dose before stopping is best.

Central nervous system stimulants like Vyvanse cause physiological changes from increased dopamine. Over time, the brain adjusts to the feelings of reward, reinforcement, and motivation. The body counteracts these effects by decreasing its sensitivity to norepinephrine and dopamine in the brain. This is one reason patients experience drug tolerance or the need for higher and higher doses to sustain the same drug efficacy. Withdrawal occurs when the body stops receiving the stimuli that it has become accustomed to. By slowly weaning off Vyvanse, the body can make small adjustments while regaining its sensitivity to dopamine and norepinephrine. When normal sensitivity is achieved, natural levels of these neurotransmitters will be enough to cause their intended functions.

Do not make abrupt changes to Vyvanse doses without first consulting a healthcare provider. Take Vyvanse consistently. Don’t skip doses. Regular dosing ensures the greatest benefit and allows doctors to evaluate how well the current dose manages ADHD. In some cases, a “drug holiday” is suggested so a patient can temporarily stop taking Vyvanse.

Drug holidays may be done for a few reasons:

When a patient’s weight decreases, pediatric patients may come off Vyvanse to allow weight gain and then restart therapy or during summer break.
To evaluate the efficacy and assess the need for continued therapy.
To avoid certain drug interactions.
- Opioids, migraine meds, anti-nausea drugs, and antidepressants have the potential to cause serotonin syndrome when taken with Vyvanse.
- Monoamine oxidase inhibitors (MAOIs) are a rarely prescribed class of antidepressants that can cause dangerously high blood pressure if taken less than 14 days before a dose of Vyvanse.

Vyvanse withdrawal timeline

Symptoms of withdrawal routinely begin within 36 hours of the last dose, can last for several days or weeks, and are more common in patients who have chronically been on a high Vyvanse dose.

Patients typically experience a noticeable drop in energy and mood as their first symptoms, which may be like symptoms of a Vyvanse crash. They may also experience a desire to eat more.

This stage is followed by physical symptoms such as joint aches and muscle pain, with continued mental health effects like irritation or depression. During this time, many patients have trouble sleeping. While this is a common pattern, the withdrawal timeline may be different for any given patient.

Vyvanse withdrawal timeline
Time Frame	Symptoms
1-2 days	Sadness, extreme fatigue, drug cravings, insomnia
3-5 days	Depression, anxiety, exhaustion, irritability, headaches, difficulty sleeping, drug cravings
1-2 weeks	Depression, anxiety, moodiness, increased appetite, difficulty concentrating
3 weeks+	Most symptoms should have subsided, but there could still be depression, difficulty concentrating and sleeping, and other lingering symptoms for high-dose or chronic Vyvanse users

How to safely stop taking Vyvanse

Stopping Vyvanse should be done under the direction of a medical professional. An appropriate tapering schedule will be suggested Patients on higher doses of Vyvanse (e.g., 70 mg) with a long duration of therapy might require a gradual dose reduction before stopping therapy and should tell their healthcare provider of any ADHD or withdrawal symptoms.

Vyvanse misuse

Recreational use, also called nonmedical use (NMU), refers to taking medications in any way other than prescribed. Studies show that 7% to 8% of US adults have lifetime nonmedical use of prescription stimulants, such as Vyvanse. It is estimated that up to 17% of college students abuse prescription stimulants, with the most common in the age range of 18 to 25 years.

Oral misuse is the most prevalent form of nonmedical use of prescription stimulants, making up 52% to 95% of all cases. This includes possessing or using stimulants without a prescription, selling or giving prescription stimulants to others, using prescription stimulants for a non-therapeutic purpose, or orally ingesting prescription stimulants in ways other than prescribed (i.e., chewing capsules). The most common method of non-oral NMU is snorting (insufflation) followed by injection, which can cause excessive harm.

Vyvanse is different from other prescription stimulants such as Adderall (amphetamine-dextroamphetamine) or Ritalin (methylphenidate) because it is inactive in its original form. Drugs that are inactive until they are metabolized are called prodrugs, which can have a lower potential for substance abuse disorders. Vyvanse is metabolized into the active drug dextroamphetamine through a chemical process called hydrolysis. This is a rate-limiting step that is responsible for the delayed and sustained effect of Vyvanse. Therefore, crushing, chewing, snorting, or injecting Vyvanse does not cause euphoria or “drug likeability,” similar to other commonly abused medications.

A study comparing intranasal and oral administration of Vyvanse showed similar effects. A study conducted among stimulant abusers showed no significant difference in “drug likability” between injected Vyvanse and placebo. However, this does not mean that alternative administration methods are safe; snorting, injecting, or ingesting Vyvanse other than prescribed opens a greater possibility of an overdose, which can be fatal.

Despite its abuse-deterrent properties, Vyvanse is categorized as a Schedule II controlled substance due to its potential for abuse and physical dependence. People can become addicted to Vyvanse when it is taken above the recommended dosage. Signs of abuse or a substance use disorder in a loved one taking Vyvanse include dilated pupils, sweating, reduced appetite, insomnia, shaking, hostility, and flushed skin. Signs of an overdose may include nausea and vomiting, diarrhea, stomach pain, muscle pain, tremors, hallucinations, confusion, panic, changes in blood pressure, aggression, rapid breathing, irregular heart rate, and loss of consciousness.

For further information about Vyvanse abuse or addiction treatment options, consult your healthcare provider for detox programs, inpatient treatment centers, or outpatient treatment programs. You can also visit the American Addiction Centers’ article on the topic.