Switching from Strattera to Vyvanse

Initiation and Titration of Vyvanse

The American College of Obstetricians and Gynecologists recommends starting Vyvanse at 20-30 mg orally once daily in the morning, with titration by 10 mg weekly increments to a maximum of 70 mg daily based on response 1, 2

Monitor for irritability, insomnia, and changes in mood with lisdexamfetamine, as recommended by Praxis Medical Insights 3
Track appetite changes, as decreased appetite is common with stimulants, and monitor height and weight, particularly in pediatric patients, as suggested by Pharmacology and Therapeutics 4
Assess pulse and blood pressure regularly, as recommended by Pharmacology and Therapeutics 4

Consider switching from atomoxetine to Vyvanse for inadequate response to atomoxetine after appropriate trial duration, or for need of more robust symptom control, as stimulants have larger effect sizes than atomoxetine, according to Pharmacology and Therapeutics 4
Vyvanse provides extended duration of action, making it a suitable option for patients requiring symptom coverage throughout the day, as noted by the American Journal of Obstetrics and Gynecology 1, 2

Vyvanse is a controlled substance, unlike atomoxetine, and this switch may not be appropriate for patients with active substance use disorders or high risk of medication diversion, as cautioned by Pharmacology and Therapeutics 4
Atomoxetine may be preferable as first-line for patients with comorbid anxiety, tics, Tourette's disorder, or substance use disorders, and if switching away from atomoxetine in these populations, ensure comorbid conditions are stable and closely monitored, as recommended by Pharmacology and Therapeutics 4