Lisdexamfetamine Dosing and Administration for ADHD and Binge Eating Disorder

Dosing and Titration

The American Academy of Child and Adolescent Psychiatry recommends titrating lisdexamfetamine doses based on clinical response and presence of side effects, continuing until symptoms have resolved and impairment has been diminished, with different target symptoms potentially requiring different doses 1
For adults, maximum daily doses may reach up to 65 mg for methylphenidate or 40 mg for dextroamphetamine/amphetamine, according to the American Academy of Child and Adolescent Psychiatry 1
Exercise caution when titrating doses in children weighing less than 25 kg, and for children weighing less than 45 lb (20 kg), omit the 15 mg dose and week in the titration schedule, as recommended by the American Academy of Child and Adolescent Psychiatry 1

Obtain rating scales from teachers and parents for children with ADHD, and for adults, collect symptom and side-effect ratings from the patient and significant others, as recommended by the American Academy of Child and Adolescent Psychiatry 1
Monitor for side effects including decreased appetite, sleep disturbances, increased blood pressure/pulse, and headaches, according to Pharmacology and Therapeutics 2
Monitor vital signs including blood pressure, pulse, height, and weight, as recommended by the American Academy of Child and Adolescent Psychiatry 1

Lisdexamfetamine has a high potential for abuse and misuse, and the drug is a controlled substance with potential for rebound of symptoms when effect wears off, according to Pharmacology and Therapeutics 2
The American Academy of Child and Adolescent Psychiatry suggests that lisdexamfetamine's prodrug formulation provides a longer duration of action compared to immediate-release stimulants, which may improve compliance, especially in adolescents 3