Vyvanse Vs. Zoloft: Drug Comparison

Vyvanse^® (lisdexamfetamine) is a stimulant medication used to treat attention-deficit hyperactivity disorder (ADHD) and binge eating disorder (BED) by increasing available levels of dopamine and norepinephrine in the brain, which helps improve focus, attention, and impulse control. Its FDA-approved indications include the treatment of ADHD in patients 6 years and older and moderate to severe binge eating disorder in adults. Vyvanse is available in capsule and chewable tablet forms, typically taken once daily in the morning. Common side effects include decreased appetite, insomnia, dry mouth, and increased heart rate, with serious risks including potential cardiovascular issues and psychiatric side effects like anxiety. Vyvanse carries a boxed warning for the high risk of abuse, dependence, and serious cardiovascular events, particularly in individuals with a history of heart problems.

Zoloft^® (sertraline) is a selective serotonin reuptake inhibitor (SSRI) used to treat mood disorders by increasing available serotonin levels in the brain, which helps improve mood and reduce symptoms of anxiety and depression. Its FDA-approved indications include the treatment of major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder (PD), post-traumatic stress disorder (PTSD), social anxiety disorder (SAD), and premenstrual dysphoric disorder (PMDD). Off-label uses may include the treatment of eating disorders and generalized anxiety disorder (GAD). Zoloft is available in tablet and oral solution forms, typically taken once daily. Common side effects include nausea, dizziness, insomnia, and sexual dysfunction, and it carries a boxed warning for an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults, particularly during the initial treatment period.

Central nervous system (CNS) stimulant

Selective serotonin reuptake inhibitor (SSRI)

Vyvanse (lisdexamfetamine dimesylate) is indicated for the treatment of:

• Attention deficit hyperactivity disorder (ADHD) in adults and pediatric patients 6 years and older

• Moderate to severe binge eating disorder (BED) in adults

Zoloft (sertraline hydrochloride) is indicated for the treatment of:

• Major depressive disorder (MDD)

• Obsessive-compulsive disorder (OCD)

• Panic disorder (PD)

• Posttraumatic stress disorder (PTSD)

• Social anxiety disorder (SAD)

• Premenstrual dysphoric disorder (PMDD)

• Typically taken orally once daily

• Comes in 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, and 70 mg capsules and 10 mg, 20 mg, 30 mg, 40 mg, 50 mg, and 60 mg chewable tablets

• Typically taken orally once daily

• Comes in 25 mg, 50 mg, and 100 mg tablets and 20 mg/mL oral solution

Most common adverse reactions (incidence ≥5% and at a rate at least twice placebo) in pediatric patients ages 6 to 17 years, and/or adults with ADHD were:

• Anorexia

• Anxiety

• Decreased appetite

• Decreased weight

• Diarrhea

• Dizziness

• Dry mouth

• Irritability

• Insomnia

• Nausea

• Upper abdominal pain

• Vomiting

Most common adverse reactions (incidence ≥ 5% and at a rate at least twice placebo) in adults with BED were:

• Dry mouth

• Insomnia

• Decreased appetite

• Increased heart rate

• Constipation

• Feeling jittery

• Anxiety

Most common adverse reactions (≥5% and twice placebo) in pooled placebo-controlled MDD, OCD, PD, PTSD, SAD and PMDD clinical trials were:

• Nausea

• Diarrhea/Loose stool

• Tremor

• Indigestion

• Decreased appetite

• Excessive sweating

• Ejaculation failure

• Decreased libido

• Known hypersensitivity to amphetamine products or other ingredients in Vyvanse

• Use with monoamine oxidase (MAO) inhibitor, or within 14 days of the last MAO inhibitor dose

• Drug interactions: Acidifying and alkalinizing agents

• Concomitant use of monoamine oxidase inhibitors (MAOIs), or use within 14 days of stopping MAOIs

• Concomitant use of pimozide

• Known hypersensitivity to sertraline or excipients

• Zoloft oral solution only: Concomitant use of disulfiram

• Drug interactions: protein-bound drugs, CYP2D6 substrates

• Risks to patients with serious cardiac disease

• Increased blood pressure and heart rate

• Long-term suppression of growth in pediatric patients

• Peripheral vasculopathy, including Raynaud's phenomenon

• Serotonin syndrome

• Motor and verbal tics, and worsening of Tourette's syndrome

• Pregnancy: May cause fetal harm

• Breastfeeding: Breastfeeding not recommended

• Serotonin syndrome

• Increased risk of bleeding

• Activation of mania/hypomania

• Seizures

• Angle closure glaucoma

• QTc prolongation

• Sexual dysfunction

• Pregnancy: Third trimester use may increase risk for persistent pulmonary hypertension and withdrawal in the neonate

WARNING: ABUSE, MISUSE, AND ADDICTION

Vyvanse has a high potential for abuse and misuse, which can lead to the development of a substance use disorder, including addiction. Misuse and abuse of CNS stimulants, including Vyvanse, can result in overdose and death:

• Before prescribing Vyvanse, assess each patient's risk for abuse, misuse, and addiction.

• Educate patients and their families about these risks, proper storage of the drug, and proper disposal of any unused drug.

• Throughout treatment, reassess each patient's risk and frequently monitor for signs and symptoms of abuse, misuse, and addiction.

WARNING: SUICIDAL THOUGHTS AND BEHAVIORS

Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients.

Closely monitor for clinical worsening and emergence of suicidal thoughts and behaviors.

*This information is from the label for brand name Vyvanse^®. See the Full Prescribing Information for more complete information. Lisdexamfetamine, the active ingredient in Vyvanse, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient lisdexamfetamine.

*This information is from the label for brand name Zoloft^®. See the Full Prescribing Information for more complete information. Sertraline, the active ingredient in Zoloft, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient sertraline.