Mechanism of Action of Vyvanse

Primary Mechanisms of Action

• The American Academy of Child and Adolescent Psychiatry emphasizes that amphetamines increase the release of dopamine and norepinephrine into the extraneuronal space, providing an additional mechanism beyond reuptake blockade alone 1

Clinical Significance of the Dual Mechanism

• The combination of reuptake inhibition and enhanced release results in a substantial increase in synaptic dopamine and norepinephrine concentrations, which improves executive function, impulse control, and working memory deficits characteristic of ADHD 1
• This dual action distinguishes amphetamines from medications like methylphenidate, which primarily work through reuptake inhibition with less direct effect on neurotransmitter release 2
• Enhanced monoamine signaling in the prefrontal cortex and striatum is associated with improved ADHD symptoms 1
• The dual mechanism (both blocking reuptake AND increasing release) is what makes amphetamines particularly effective for ADHD, with 70-80% response rates when properly titrated 2, 3