PSYCHOPHARMACOLOGY Focus on Lisdexamfetamine: A Review of its use in Child and Adolescent Psychiatry

Objective: To summarize and review published literature regarding lisdexamfetamine and its use in child and adolescent psychiatry. Method: A literature review was conducted using the PubMed search term: ‘lisdexamfetamine ’ with limits: Human trials, English language, All Child (aged 0-18 years). Additional articles were identified from reference information and poster presentation data. Results: Lisdexamfetamine (Vyvanse®) is a prodrug formulation of dextroamphetamine used for the treatment of Attention Deficit/Hyperactivity Disorder (ADHD). Conversion of lisdexamfetamine to active dextroamphetamine occurs via hydrolytic enzymes located on erythrocytes, and leads to an onset of action within 1-2 hours post-dose, and duration of up to 13 hours. Administration of lisdexamfetamine via nasal or intravenous routes did not result in significant elevation of drug liking scores in known stimulant abusers, suggesting low potential for abuse. Lisdexamfetamine has been available in the United States since 2007, but was only recently approved by Health Canada for use in children 6 to 12 years of age. There are five randomized controlled trials with lisdexamfetamine in children and adolescents showing efficacy for treatment of ADHD. In addition, several open-label trials and case reports were identified. The adverse effect profile of lisdexamfetamine is similar to that observed with other long-acting amphetamine formulations. Conclusion: Lisdexamfetamine is a novel long-acting stimulant formulation with efficacy for treatment of ADHD and low abuse potential due to its prodrug formulation.