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| {{SubstanceBox/Lisdexamfetamine}}
| | #REDIRECT [[Lisdexamfetamine]] |
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| '''Lisdexamphetamine''' (full name '''L-lysine-dextroamphetamine''', brand names '''Vyvanse''', '''Elvanse''') is a [[prodrug]] for dextro-[[amphetamine]], a strong central nervous system stimulant. It is indicated for the medical treatment of ADHD and moderate to severe binge-eating disorder.<ref>https://www.drugs.com/pro/vyvanse.html</ref>
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| Like other amphetamines, it is also used illicitly as a study drug and for recreational purposes.
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| While amphetamine sulfate contains 50% L-amphetamine, and the ADHD medication Adderall contains a mix of four amphetamine salts totaling 75% D-amphetamine and 25% L-amphetamine, lisdexamfetamine, once converted into an active form, is pure dextroamphetamine. This leads to stronger central and weaker peripheral nervous system effects. Lisdexamphetamine effects are independent of the route of administration, and oral is, therefore, the preferred method of ingestion, unlike other amphetamines, which are insufflated, smoked or injected by some recreational users.
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| ==Chemistry==
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| Lisdexamphetamine consists of the dextro-rotary stereoisomer of [[amphetamine]] bonded to the essential amino acid lysine. See the entry on [[Amphetamine#Chemistry|amphetamine]].
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| ==Pharmacokinetics==
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| As a [[prodrug]], lisdexamfetamine is inactive in the form administered. Once ingested, it is enzymatically cleaved into L-lysine, a naturally occurring essential amino acid, and D-amphetamine, a central nervous system stimulant. Thus lisdexamfetamine functions as an extended release version of dexamphetamine. Because D-amphetamine needs to be liberated from lysine via contact with red blood cells, effects are independent of the route of administration. Conversion of lisdexamfetamine into active D-amphetamine is enzymatically rate-limited, slowing down the time to achieve and decreasing the magnitude of peak concentration of active substance and subsequent striatal dopamine release.<ref>http://www.sciencedirect.com/science/article/pii/S0028390814000781</ref>
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| ==Pharmacodymanics==
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| Amphetamine is a [[Agonist|full agonist]] of the trace amine-associated receptor 1 (TAAR1), which is a key regulator of common and trace brain monoamines such as [[dopamine]], [[serotonin]] and [[noradrenaline]].<ref>The Emerging Role of Trace Amine Associated Receptor 1 in the Functional Regulation of Monoamine Transporters and Dopaminergic Activity (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3005101/</ref><ref>Drug banks amphetamine targets | http://www.drugbank.ca/drugs/DB00182#targets</ref><ref>TA1 receptor | http://www.iuphar-db.org/DATABASE/ObjectDisplayForward?objectId=364</ref> The agonism of this set of receptors results in the release of increased concentrations of dopamine, serotonin and noradrenaline in the synaptic cleft. This leads to [[Thought acceleration|cognitive]] and [[Stimulation|physical stimulation]] within the user.
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| D-amphetamine's affinity for the TAAR1 receptor is twice that of L-amphetamine.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236098/</ref> As a result, D-amphetamine produces three to four times as much Central Nervous System stimulation as L-amphetamine. L-amphetamine, on the other hand, has stronger cardiovascular and peripheral effects.
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| ==Subjective effects==
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| {{Preamble/SubjectiveEffects}}
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| ===Physical effects===
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| *'''[[Effect::Spontaneous tactile sensations]]''' - The "body high" of amphetamine can be described as a moderate euphoric tingling sensation that encompasses the entire body. This sensation maintains a consistent presence that steadily rises with the onset and hits its limit once the peak has been reached.
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| *'''[[Effect::Stimulation]]''' - In terms of its effects on the physical energy levels of the user, amphetamine is usually considered to be moderately energetic and stimulating in a fashion that is slightly weaker to that of [[methamphetamine]], but stronger than that of [[modafinil]], [[caffeine]], and [[methylphenidate]]. It is similar, yet distinct, from the stimulation experienced on [[MDMA]], encouraging physical activities such as dancing, socializing, running, or cleaning. The particular style of stimulation which amphetamine presents can be described as forced. This means that, at higher dosages, it becomes difficult or impossible to keep still as jaw clenching, involuntarily bodily shakes and vibrations become present, resulting in extreme shaking of the entire body, unsteadiness of the hands, and a general lack of motor control.
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| *'''[[Effect::Abnormal heartbeat]]'''
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| *'''[[Effect::Appetite suppression]]'''
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| *'''[[Effect::Bronchodilation]]'''
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| *'''[[Effect::Dehydration]]'''
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| *'''[[Effect::Frequent urination]]'''
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| *'''[[Effect::Increased bodily temperature]]''' {{citation needed}}
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| *'''[[Effect::Increased blood pressure]]''' {{citation needed}}
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| *'''[[Effect::Increased heart rate]]''' {{citation needed}}
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| *'''[[Effect::Increased perspiration]]'''
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| *'''[[Effect::Nausea]]'''
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| *'''[[Effect::Perception of decreased weight]]'''
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| *'''[[Effect::Pupil dilation]]'''
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| *'''[[Effect::Stamina enhancement]]'''
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| *'''[[Effect::Teeth grinding]]'''
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| *'''[[Effect::Temporary erectile dysfunction]]'''
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| *'''[[Effect::Vasoconstriction]]''' {{citation needed}}
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| ===Cognitive effects===
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| *'''[[Effect::Analysis enhancement]]'''
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| *'''[[Effect::Cognitive euphoria]]'''
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| *'''[[Effect::Compulsive redosing]]'''
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| *'''[[Effect::Dream suppression]]'''
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| *'''[[Effect::Ego inflation]]'''
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| *'''[[Effect::Focus enhancement]]''' - This component is most effective at low to moderate doses as anything higher will usually impair concentration.
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| *'''[[Effect::Increased libido]]'''
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| *'''[[Effect::Increased music appreciation]]'''
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| *'''[[Effect::Memory enhancement]]'''
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| *'''[[Effect::Motivation enhancement]]'''
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| *'''[[Effect::Thought acceleration]]'''
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| *'''[[Effect::Thought organization]]'''
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| *'''[[Effect::Wakefulness]]'''
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| ===Visual effects===
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| The visual effects of amphetamine are usually less consistent and are only mildly noticeable at higher dosages. They are somewhat comparable to [[deliriants]] and are more frequent in darker areas. Effects intensify with sleep deprivation, and long binges without sleep can escalate into full-blown [[stimulant psychosis]].
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| ====Suppressions====
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| *'''[[Effect::Double vision]]'''
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| ====Distortions====
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| *'''[[Effect::Visual drifting|Drifting]]''' ''([[Visual drifting#Breathing|breathing]] and [[Visual drifting#Morphing|morphing]])'' - This effect is usually subtle and barely noticeable and only occurs at higher dosages or when combined with [[cannabis]]. Commonly this consists of level 1-2 drifting.
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| *'''[[Effect::Brightness alteration]]'''
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| ====Hallucinatory states====
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| *'''[[Effect::Transformations]]''' - These are usually very mild.
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| ===After effects===
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| The effects which occur during the [[offset]] of a [[stimulant]] experience generally feel negative and uncomfortable in comparison to the effects which occurred during its [[peak]]. This is often referred to as a "comedown" and occurs because of [[neurotransmitter]] depletion. Its effects commonly include:
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| *'''[[Effect::Anxiety]]'''
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| *'''[[Effect::Appetite suppression]]'''
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| *'''[[Effect::Cognitive fatigue]]'''
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| *'''[[Effect::Depression]]'''
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| *'''[[Effect::Irritability]]'''
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| *'''[[Effect::Motivation suppression]]'''
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| *'''[[Sleep paralysis]]''' - Some users note sleep paralysis after consuming amphetamine.
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| *'''[[Effect::Thought deceleration]]'''
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| *'''[[Effect::Wakefulness]]'''
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| ===Experience reports===
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| There are currently no anecdotal reports which describe the effects of this compound within our [[experience index]]. Additional experience reports can be found here:
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| * [https://erowid.org/experiences/subs/exp_Lisdexamfetamine.shtml Erowid Experience Vaults: Lisdexamphetamine]
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| ==Toxicity and Harm Potential==
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| Like other amphetamines, lisdexamfetamine is addictive and sufficiently high doses can cause neurotoxicity. Other dangers include [[stimulant psychosis]].
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| The addiction and harm potential of lisdexamfetamine is theoretically lower than that of straight amphetamine due to the rate-limiting step of hydrolysis necessary to convert LDX into active D-amphetamine. Caution is nonetheless warranted.
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| ===Dangerous interactions===
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| {{DangerousInteractions/Intro}}
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| *'''[[Stimulants]]''' - Amphetamine can be potentially dangerous in combination with other [[stimulant]]s as it can [[increased heart rate|increase one's heart rate]] and [[increased blood pressure|blood pressure]] to dangerous levels.
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| *'''[https://en.wikipedia.org/wiki/Tricyclic_antidepressant Tricyclic antidepressants]''' - Amphetamine may increase the effects of tricyclic antidepressants to dangerous levels.<ref>Adderall Prescription info | http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf</ref>
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| {{DangerousInteractions/Stimulants|self=amphetamines}}
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| *'''[[MDMA]]''' - The neurotoxic effects of [[MDMA]] may be increased when combined with amphetamines.
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| {{DangerousInteractions/MAOI|nt=dopamine}}
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| *'''[[Cocaine]]''' - This combination may increase strain on the heart.
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| Please refer to the article on [[Amphetamine#Toxicity_and_harm_potential|amphetamine]] for a more thorough discussion of tolerance, toxicity and harm potential.
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| ==Legal issues==
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| Lisdexamphetamine is approved for medical use with a doctor's prescription, but in most countries, it is illegal to sell or possess without a prescription.
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| *'''UK''': Lisdexamfetamine is a Class B scheduled drug.
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| *'''US''': It is a Schedule II controlled drug.
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| *'''Germany''': Lisdexamphetamine is scheduled in Anlage III.<ref>https://en.wikipedia.org/wiki/Drugs_controlled_by_the_German_Bet%C3%A4ubungsmittelgesetz#Anlage_III</ref>
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| *'''Australia''': It is a Schedule 8 drug.
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| *'''Canada''': Lisdexamfetamine is a Schedule I drug.
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| *'''Norway''': Elvanse is a Class A drug under particularly strict control.<ref>http://www.felleskatalogen.no/medisin/elvanse-shire-pharmaceutical-contracts-ltd-588199</ref>
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| *'''Sweden''': Elvanse is a Class II narcotic, with strict requirements for prescription. It has been placed under "utökad övervåkande" (extended surveillance).<ref name="swe">http://www.fass.se/LIF/product?userType=2&nplId=20140730000117</ref>
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| *'''Schengen Area''': Lisdexamphetamine requires a special certificate while traveling within the [https://en.wikipedia.org/wiki/Schengen_Area Schengen Area], which covers most of Europe, but not the United Kingdom.<ref name="swe"></ref>
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| ==See also==
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| *[[Responsible use]]
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| *[[Stimulants]]
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| *[[Modafinil]]
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| *[[Substituted amphetamines]]
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| *[[DOM]]
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| *[[MDMA]]
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| *[[Prodrug]]
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| ==External links==
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| *[http://en.wikipedia.org/wiki/Amphetamine Amphetamine (Wikipedia)]
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| *[http://en.wikipedia.org/wiki/Lisdexamphetamine Lisdexamphetamine (Wikipedia)]
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| *[http://www.erowid.org/chemicals/amphetamines/ Amphetamine (Erowid)]
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| *[https://www.erowid.org/experiences/subs/exp_Amphetamines.shtml Amphetamine experiences (Erowid)]
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| *[https://erowid.org/experiences/subs/exp_Lisdexamfetamine.shtml Lisdexamphetamine experiences (Erowid)]
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| *[http://drugs.tripsit.me/amphetamine Amphetamine (TripSit)]
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| *[http://drugs.tripsit.me/vyvanse Vyvanse (TripSit)]
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| *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/ Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review]
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| *[https://www.nlm.nih.gov/medlineplus/druginfo/meds/a601234.html Dextroamphetamine and Amphetamine (Medicine Plus)]
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| ==References==
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| <references/>
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