Adderall and Vyvanse: the strongest ADHD meds
Adderall, Vyvanse (Elvanse) and dexamfetamine are amphetamine medicines, the most effective ADHD treatment in adults. How they differ, doses, side effects, Vyvanse for binge eating and what users say.
Amphetamines are the most powerful ADHD medicines we have. In a large comparison of ADHD treatments they had the biggest effect in adults of any medicine studied. Three are in common use: Adderall, a mix of amphetamine salts; Vyvanse, sold as Elvanse in the UK, which the body slowly turns into dexamfetamine; and plain dexamfetamine. They work fast, they work for most people, and they come with a strong warning about misuse.
Key points
- Adderall XR and Vyvanse are licensed in the US for ADHD in adults and children 6 and over. Vyvanse is also licensed for binge eating disorder in adults.
- In the UK, lisdexamfetamine (Elvanse) is a first choice for adults with ADHD, alongside methylphenidate.
- Common side effects: dry mouth, less appetite, trouble sleeping, headache and a faster heartbeat.
- Controlled drugs: Schedule II in the US, Class B in the UK. Never share them, and keep them locked away.
Adderall, Vyvanse and dexamfetamine: what’s the difference?
| Adderall XR | Vyvanse (Elvanse) | Dexamfetamine | |
|---|---|---|---|
| What it is | a mix of amphetamine salts, slow-release beads | lisdexamfetamine, which the body converts into dexamfetamine | the active form on its own |
| Taken | once in the morning | once in the morning | as your prescriber directs; forms vary |
| Can it be opened? | yes, sprinkled on applesauce | yes, mixed into yogurt, water or orange juice; also a chewable tablet | n/a |
| Also licensed for | nothing else | binge eating disorder (US adults) | nothing else |
Because Vyvanse has to be converted by the body before it works, its effect builds more gradually, and many people describe it as smoother. Adderall comes as short-acting tablets and as the once-a-day XR capsule.
Where they are licensed
- United States: Adderall XR and Vyvanse for ADHD in adults and children 6 and over; Vyvanse also for moderate to severe binge eating disorder in adults. Not recommended under 6. Schedule II.
- United Kingdom: NICE suggests lisdexamfetamine or methylphenidate first for adults, and lisdexamfetamine for children whose 6-week trial of methylphenidate didn’t help enough. Dexamfetamine is an option for people who respond to lisdexamfetamine but can’t handle how long it lasts. Amphetamine and lisdexamfetamine are Class B, Schedule 2.
How much people take
Your prescriber sets the dose.
| Start | Steps | Usual maximum | |
|---|---|---|---|
| Vyvanse, ADHD | 30 mg in the morning | up 10 or 20 mg about weekly | 70 mg a day |
| Vyvanse, binge eating | 30 mg in the morning | up 20 mg weekly to 50 to 70 mg | 70 mg a day |
| Adderall XR, adults | 20 mg a day | weekly, as needed | individual |
| Adderall XR, children 6 to 12 | 10 mg in the morning (or 5 mg) | 5 or 10 mg weekly | 30 mg a day |
- Take them in the morning. Afternoon doses are likely to keep you awake.
- Don’t split a dose. Take the whole capsule or the whole mixed contents.
- Kidney disease lowers the maximum Vyvanse dose.
Side effects
Adderall XR in adults (191 on Adderall XR, 64 on placebo, doses up to 60 mg):
| Side effect | Adderall XR | Placebo |
|---|---|---|
| Dry mouth | 35% | 5% |
| Less appetite | 33% | 3% |
| Trouble sleeping | 27% | 13% |
| Headache | 26% | 13% |
| Agitation | 8% | 5% |
| Anxiety | 8% | 5% |
| Nausea | 8% | 3% |
| Dizziness | 7% | 0% |
| Fast heartbeat | 6% | 3% |
Vyvanse in adults with binge eating disorder (373 on Vyvanse, 372 on placebo): dry mouth 36% against 7%, trouble sleeping 20% against 8%, less appetite 8% against 2%, faster heart rate 7% against 1%, feeling jittery and constipation 6% each against 1%, anxiety 5% against 1%. In adults with ADHD the most common were much the same.
Good to know
- Heart: like other stimulants, they raise blood pressure and pulse a little. Your prescriber asks about heart problems and family history first.
- Children’s growth is tracked, and stimulants can worsen tics.
- Mood and thinking: in rare cases stimulants trigger psychotic or manic symptoms.
- Not for weight loss. The Vyvanse label is explicit: it isn’t licensed or recommended for losing weight.
- Pregnancy: the data are too limited to give a clear answer; talk it through with your prescriber.
Medicines that don’t mix
- MAOI antidepressants: never together, and 14 days apart.
- Serotonin-boosting medicines such as SSRIs, SNRIs, triptans and tramadol: the combination can, rarely, cause serotonin syndrome, so your prescriber watches for it.
- Blood pressure medicines may work less well.
How well they work
In the 2018 Lancet Psychiatry comparison of ADHD medicines, amphetamines had the largest effect of any medicine in both children and adults, and in adults they came out ahead of methylphenidate, atomoxetine and modafinil in head-to-head comparisons. The trade-off was tolerability: more people stopped amphetamines than placebo because of side effects. Taking both into account, the authors named amphetamines the preferred first choice for adults.
For binge eating, a 2015 trial in 255 adults found that 50 mg and 70 mg of lisdexamfetamine cut binge days more than placebo, and the US later licensed it for this use.
What people say
Our Reddit sample was gathered around non-stimulants and modafinil, so stimulants appear mostly in comparisons. Read these as examples.
- Smoother for some. “I switched to Vyvanse, it works better for me with less side effects.” (r/ADHD)
- Not always enough alone. “I always felt like vyvanse was doing just half the job.” (r/ADHD) That person added atomoxetine.
- Tolerance worries. “Adderall wasn’t working as well for me anymore. Tolerance and bad side effects.” (r/modafinil)
- Sleep. “the effects seemed to last for twice as long as they were supposed to” (r/modafinil), which is why doses are taken early.
- Teeth and appetite. “the side effects were terrible for me (teeth grinding, no appetite)” (r/Narcolepsy).
Where to get them
Amphetamines are controlled medicines available only on prescription, and we don’t list pharmacies for them. If they aren’t an option for you, see the non-stimulant options, and for the comparison many people search for, modafinil.
Questions people ask
What's the difference between Adderall and Vyvanse?
Adderall is a mix of amphetamine salts that works directly. Vyvanse is lisdexamfetamine, which your body turns into dexamfetamine, so its effect builds more gradually. Both are taken once a day in their long-acting forms.
Is Elvanse the same as Vyvanse?
Yes. Elvanse is the UK and European name for lisdexamfetamine, sold as Vyvanse in the US.
Is Vyvanse approved for binge eating?
In the US, yes, for moderate to severe binge eating disorder in adults. In the UK that use is off-label. It isn’t approved for weight loss.
Which works better, Adderall or Ritalin?
In adults, a large review found amphetamines had the bigger effect; for children it recommended methylphenidate first. Many people try both. See methylphenidate.
Is modafinil like Adderall?
Not really. Modafinil mainly keeps you awake and is milder; on Reddit, long-term Adderall users often say it doesn’t replace it. See modafinil.
Sources
Checked 17 October 2026.
- Vyvanse (lisdexamfetamine) prescribing information — Takeda, via DailyMed
- Adderall XR (mixed amphetamine salts extended-release) prescribing information, revised May 2026 — Takeda, via DailyMed
- Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations 1.7.8 to 1.7.14 — NICE (UK)
- List of most commonly encountered drugs controlled under the misuse of drugs legislation — Home Office (UK), updated 1 April 2025
- Comparative efficacy and tolerability of ADHD medications, network meta-analysis (Cortese et al., 2018) — The Lancet Psychiatry
- Lisdexamfetamine for adults with moderate to severe binge-eating disorder (McElroy et al., 2015) — JAMA Psychiatry