Common Vyvanse side effects in men

Heart problems, priapism, and erectile dysfunction are possible Vyvanse side effects in males

By Chad Shaffer, MD | Mar. 25, 2022

Vyvanse (lisdexamfetamine dimesylate) is a less renowned cousin of Adderall (dextroamphetamine-amphetamine). Like Adderall, Vyvanse is a central nervous system stimulant. Vyvanse triggers the release of the neurotransmitters dopamine and norepinephrine within our nerve endings to produce myriad effects, both for the better and worse. This brand-name prescription drug is approved by the Food and Drug Administration (FDA) for treatment of attention-deficit/hyperactivity disorder (ADHD) and binge eating disorder. It’s prescribed to men, women, and children. All patients can experience Vyvanse side effects, but there are some that are specific to men.

RELATED: Vyvanse vs. Adderall

ADHD and binge eating disorders in males

Symptoms of ADHD inattentiveness, impulsiveness, and restlessness. These deficits manifest as difficulty with organizing oneself and in identifying and working toward goals. Consequently, challenges can arise in the workplace, from limiting professional advancement to maintaining employment. The difficulties can also extend to social elements and relationships, as a result of struggles with regulating emotions.

In the U.S., about 4% of those between ages 18 and 44 are estimated to have ADHD. It is more common in males. Vyvanse has been shown to improve the functioning and quality of life of adults with ADHD.

Vyvanse is also approved to treat moderate to severe binge eating disorders. Unfortunately, eating disorders get much less attention from men, and this is because of a gross lack of recognition. The reality is that 10 million men in the U.S. will experience an eating disorder. The most common of these is binge eating disorder, defined as eating an abnormally large amount in a relatively short period of time (two hours or less) at least weekly for more than three months. Binge eating disorder afflicts 2% of U.S. men, and less than half of them seek treatment.

There are effective treatments available for binge eating disorder. Counseling is often a first choice, and medications are another good option. The drug classes that are used include antidepressants, seizure medications, and central nervous system (CNS) stimulants like Vyvanse. Vyvanse can more than double the chance of abstaining from binges compared to placebo (an inactive drug for comparison in studies).

What are common Vyvanse side effects in males?

Anorexia (reduced appetite) or weight loss
Dry mouth
Jitteriness, tremor, or anxiety
Insomnia or nightmares
Nausea, vomiting, diarrhea, constipation, gastroenteritis, or abdominal pain
Heart rate or blood pressure elevation
Agitation or rapidly changing mood
Impotence, erectile dysfunction, or priapism (painful, prolonged erection)
Rash
Dizziness
Increase in tic frequency
Shortness of breath
Urinary tract infection
Mouth or throat pain
Fever
Sleepiness
Abnormal sensations
Visual disturbance

Cardiac side effects

When looking over the list of common side effects of Vyvanse, most men considering it would be spooked by the problems related to erections, and these issues certainly warrant concern. However, the potential for cardiac side effects, such as elevated heart rate or blood pressure, may be more important. The fact is that the possible serious side effects of Vyvanse include heart attack, stroke, sudden death, and cardiomyopathy (heart muscle problems). Males should make note of this because heart disease is more common in men, killing 1 in 4 American men compared to 1 in 5 American women. Vyvanse is contraindicated, meaning not to be used, by those with heart disease, including coronary artery disease, cardiomyopathy, and heart rhythm problems.

Priapism

Priapism is a prolonged, painful penile or clitoral erection. Beginning at the time of sexual intercourse or for unknown reasons, the erection continues on for hours in an unwanted manner. It can become a medical emergency if the tissue is not getting adequate circulation. The FDA had warned of priapism with CNS stimulant medications, and a case of priapism associated with Vyvanse has been reported.

Erectile dysfunction

Difficulty achieving or maintaining an erection is termed impotence or erectile dysfunction (ED). Approximately 30 million American men experience ED, and it is likely something nearly all men worry about. ADHD medications may increase the risk. Vyvanse was associated with ED in 2.6% of adult men in a study compared to 0% of those taking a placebo.

Vyvanse and testosterone levels

Noticing the side effect list includes problems with erections and a propensity for agitation, a man might naturally wonder if CNS stimulants like Vyvanse affect testosterone levels. With emotional regulation already being a problem in ADHD, any worsening would obviously want to be avoided. A study examined this question and fortunately did not find any differences in testosterone level.

Vyvanse weight loss

With 1 in 3 adults weighing enough to be considered obese, weight loss is on many people’s minds. The incidence of obesity in men is somewhat lower than in women. Seeing appetite reduction and weight loss listed as possible side effects of Vyvanse and other stimulants may seem more like side benefits to many readers. Males, however, seem to experience this effect less often than females.

Abuse and dependency

The FDA has applied its highest level of warning label, a black box warning, to CNS stimulants like Vyvanse due to their high potential for abuse and dependency. These drugs can be misused or diverted to others. The Drug Enforcement Administration (DEA) lists Vyvanse as a category II controlled substance for these reasons. On the bright side, the risk is much lower than that of opiate pain relievers, and compared to its cousins including Adderall, Vyvanse had a lower rate of misuse in one study.

How to take Vyvanse to avoid side effects

There are a number of ways to reduce the risk of adverse effects from Vyvanse.

1. Take the correct dosage

First of all, it is vital to take the medication exactly as prescribed by your healthcare provider. The drug is usually started at a dose of 30 mg per day and can be gradually increased to 70 mg per day if necessary. To limit insomnia, your dose should be taken in the morning, with or without food. Changes to the dosing should only be done in consultation with the prescribing healthcare professional.

2. Be aware of Vyvanse interactions

Before you even start Vyvanse, you should sit down with the prescriber and fully review your list of prescription drugs, over-the-counter medications, and supplements. This is important because a number of medications can interact with Vyvanse. For example, many different antidepressants can be a problem, which is particularly vexing because of the significant incidence of coinciding depression and ADHD. Antidepressants of concern include those that can increase blood pressure, such as Effexor XR (venlafaxine), heighten seizure risk, such as Wellbutrin XL (bupropion), or increase serotonin levels, such as Zoloft (sertraline). Use of monoamine oxidase inhibitors (MAOIs) like linezolid and selegiline is contraindicated altogether within 14 days of Vyvanse.

Men may be rightfully concerned about interactions with blood pressure medications, testosterone, and alcohol. Norvasc (amlodipine) and other blood pressure pills may not work as well when Vyvanse is used. Testosterone replacement could create an additive degree of blood pressure or heart rate elevation along with Vyvanse. Alcohol use with Vyvanse and other stimulants is best avoided. Besides the ones listed here, the list of drug interactions is lengthy and warrants a focused conversation with the healthcare provider.

3. Do not use Vyvanse if you have certain medical conditions

At the same time, a review of your medical history is worthwhile. A history of heart problems is a contraindication to the use of Vyvanse. Usage of the drug should also be questioned if there is a family history of hypertension (high blood pressure), circulation problems, seizures, mental health problems like psychosis or bipolar disorder, alcoholism, Tourette Syndrome, or other tic disorder, or drug abuse.

4. Seek ED treatments if needed

Naturally, the chance of erectile dysfunction may spook some men away from Vyvanse and other amphetamines for ADHD treatment. However, the risk is low, and if ED is experienced, it can be offset by treatment with medicine like Viagra (sildenafil) if desired. The other option would be to change to a different ADHD medication with less ED risk, such as Focalin XR (extended release dexmethylphenidate).

5. Do not suddenly stop using Vyvanse

If the time comes to stop Vyvanse, you should get medical advice then as well. Most times, the medicine can be stopped without having withdrawal effects. If you have taken high doses for a long period, withdrawal symptoms might occur, so a taper of the dose may be recommended.

The adverse effects and potential hazards of this drug can be intimidating. They should certainly be respected. Despite these concerns, Vyvanse remains a helpful agent for many men with ADHD and binge eating disorder.