Dosing and Monitoring of Vyvanse for ADHD

Initial Dosing and Titration

• The American Academy of Child and Adolescent Psychiatry recommends assessing clinical response and tolerability before each dose increase to minimize side effects, with weekly contact maintained by telephone during initial titration and dose adjustments, which typically requires 2-4 weeks to reach optimal dosing, and after stabilization, follow-up appointments should be scheduled at least monthly 1
• Systematically assess for side effects by asking specific questions about known stimulant side effects such as insomnia, anorexia, headaches, and weight loss, and monitor weight regularly as weight loss is a common side effect of stimulant medications 1

Dose Adjustment and Alternative Treatments

• If adequate symptom control is not achieved at the maximum dose, consider alternative treatments or adding non-stimulant medications, according to Pharmacology and Therapeutics 2

Pitfalls to Avoid

• Starting at too high a dose can lead to unnecessary side effects and decreased medication adherence, and failure to systematically assess both benefits and side effects during titration, according to the American Academy of Child and Adolescent Psychiatry 1

Vyvanse Dosage Guidelines for ADHD

Introduction to Vyvanse Dosage

• The American College of Obstetricians and Gynecologists recommends starting with 30 mg of Vyvanse once daily in the morning, with typical maintenance doses ranging from 50-70 mg daily after titration 3

Starting Dose and Titration

• The standard initial dose of Vyvanse is 30 mg once daily in the morning, which represents the standard initial dose across most treatment guidelines 3
• Increase the dose by 10 mg weekly based on clinical response and tolerability 3

Maintenance Doses

• The therapeutic dose range of Vyvanse is 30-70 mg daily, with 50-70 mg representing the most common maintenance doses in clinical practice 3
• The maximum approved daily dose of Vyvanse is 70 mg 3

Vyvanse Dosing and Monitoring for ADHD

Initial Assessment and Monitoring

• The American Academy of Child and Adolescent Psychiatry recommends obtaining ADHD rating scales from teachers and parents for children, or from the patient and significant others for adults, to assess therapeutic response and side effects 4
• The American Academy of Child and Adolescent Psychiatry suggests monitoring patients at least monthly after stabilization to assess ongoing efficacy, side effects, and growth parameters, such as height, weight, blood pressure, and pulse 4

Lisdexamfetamine Dosing and Monitoring for ADHD

Ongoing Monitoring and Treatment Considerations

• The American Academy of Pediatrics recommends scheduling follow-up appointments at least monthly to assess ongoing efficacy, side effects, and growth parameters, and to continue regular assessment as dose adjustments are common due to changes in symptomatology, psychosocial situation, or normal development 5
• The National Institute of Mental Health suggests that if adequate symptom control is not achieved at the maximum dose, consider alternative treatments or adding non-stimulant medications, and lisdexamfetamine should be the preferred next option over non-stimulants if no desired benefit is observed after adequate treatment with methylphenidate 5