CNS Drug Paper

Vyvanse versus Concerta in Adolescents with ADHD By: Sienna Lawson Introduction Both lisdexamfetamine dimesylate and osmotic-release oral system methylphenidate, their brand names being Vyvanse and Concerta, are commonly used to treat adolescents ages 13-17, with attention-deficit hyperactivity disorder (ADHD). While both of these are commonly prescribed for this disorder, questions still remained about the effectiveness of amphetamine-based versus methylphenidate-based agents. Analysis The data shown represents a comparative study, one being a flexible-dose and the other being a forced-dose. A flexible-dose study allows the participant to take whatever dose of the randomized medication best fits their needs. However, a forced-dose study requires every participant to take the same dosage of the randomized medication, no matter their need. The three medications offered in both studies are Vyvanse, Concerta, and placebo. In the flexible-dose study, the participants are given either a placebo pill to take daily, a range from 30-70 mg of Vyvanse that they are to take daily for 8 weeks, or 18-72 mg of Concerta, taken at the same frequency. The participants of the forced-dose study are given either 70 mg of Vyvanse, 72 mg of Concerta, or a placebo pill that they are to take daily for 6 weeks. At the end of each study, participants took the Attention- Deficit/Hyperactivity Disorder Rating Scale IV, which is a test that commonly diagnoses ADHD, along with the Clinical Global Impressions of Improvement scale. In both studies, the results favor Vyvanse and Concerta over placebo. However, in only the forced-dose study, Vyvanse is heavily favored over Concerta. The results of the two medications are similar in the flexible-dose study. Based on the CGI-I conducted at the end of treatment, the percentage of improvement after the forced-dose study was 81.4% versus 71.3%, with Vyvanse being the more effective option. Although, in the flexible-dose study, Vyvanse and Concerta were much closer at 83.1% and 81.0% improvement. Aside from the improvement, participants also faced some negative side effects from both medications. These include decreased appetite, decreased weight, insomnia, and dry mouth. Participants on Vyvanse also experienced irritability and dizziness while those on Concerta experienced a higher heart rate. Conclusion This comparative study proved that both amphetamine-based and methylphenidate-based stimulants are effective in adolescents with ADHD. While Vyvanse, the amphetamine- based agent, was superior in the forced-dose study, Concerta was equally as effective in the flexible- dose study. This shows that when prescribed the proper dosage, both medications can properly treat ADHD.