Switching from Vyvanse to Focalin XR: A Guideline Summary

Introduction to Medication Conversion

Vyvanse 40mg is a prodrug that converts to dextroamphetamine, providing amphetamine-based stimulation throughout the day, according to the American Journal of Obstetrics and Gynecology 1, 2, 3

Discontinue Vyvanse abruptly without tapering when switching to Focalin XR, as amphetamines can be stopped immediately when transitioning to another ADHD medication, as recommended by Praxis Medical Insights 4
No washout period is required between stopping Vyvanse and starting Focalin XR, as these medications work through different mechanisms (amphetamine vs. methylphenidate), according to Praxis Medical Insights 4

Titrate weekly in increments of 5mg if symptom control is inadequate, assessing response through parent and teacher reports, as suggested by the Journal of the American Academy of Child and Adolescent Psychiatry 5
Expect immediate therapeutic effects with Focalin XR, unlike non-stimulant alternatives which require 6-12 weeks for full efficacy, according to Praxis Medical Insights 4

Assess target ADHD symptoms weekly during titration using standardized rating scales from both parents and teachers, as recommended by the Journal of the American Academy of Child and Adolescent Psychiatry 5
Weigh the patient at each visit to objectively monitor for appetite suppression and weight loss, according to the Journal of the American Academy of Child and Adolescent Psychiatry 5
Systematically assess for specific side effects including insomnia, decreased appetite, headaches, social withdrawal, and tics, as suggested by the Journal of the American Academy of Child and Adolescent Psychiatry 5

If inadequate response occurs after 4 weeks at maximum tolerated dose, consider switching back to an amphetamine-based stimulant rather than further dose escalation, as recommended by the Journal of the American Academy of Child and Adolescent Psychiatry 5