Vyvanse may in some cases be prescribed off-label for the treatment of anxiety.
Vyvanse is comprised of lisdexamfetamine, which is dextroamphetamine conjugated to the amino acid lysine. This formulation results in the gradual, more controlled (rather than instant) release of amphetamine.
It is interesting that Vyvanse or Adderall may exacerbate anxiety in some patients and radically alleviate anxiety in others. This observation highlights how heterogeneous psychiatric disorders are, and how differently people respond to medications. Everyone has a unique neurochemical milieu.
An excellent comparison of the relative merits and demerits of Vyvanse vs Adderall can be found here.
Vyvanse Exacerbates Anxiety in Some Patients
Amphetamines are catecholamine releasing agents. That is, they promote the release of norepinephrine and dopamine in the synapse. Norepinephrine plays a role in the sympathetic (fight-or-flight) response to perceived danger or stress, and therefore can increase heart rate, blood pressure and affect other vital parameters. For this reason, amphetamines can be anxiogenic (anxiety-promoting) in some subjects, because amphetamine elicits norepinephrine release.
Social Anxiety May Respond to Vyvanse
However, certain specific kinds of anxiety disorders, like debilitating social anxiety, can sometimes respond to Vyvanse treatment. In situations where social anxiety is caused by impaired dopaminergic signaling that leads to reduced social confidence, Vyvanse can help relieve anxiety. A recent study suggests that patients with social anxiety have too much serotonin (rather than too little, as previously thought). As a crude overgeneralization, dopamine and serotonin counterbalance each other, such that excessive serotononergic signaling inhibits dopamine release, and vice-versa.
For this reason, patients with social anxiety and low self-confidence may benefit socially through Vyvanse treatment.
Interrelationships Between Anxiety and ADHD
Anxiety disorders are often co-morbid with attention-deficit hyperactivity disorders (ADHD). The challenges that patients with ADHD face performing every day tasks can lead to heightened anxiety. This anxiety may stem from an inability to concentrate on demanding tasks. Children with ADHD may also develop social anxiety because it may be difficult to learn social cues and appropriate social behavior if a patient is constantly distracted or inattentive.
In anxiety disorders that are secondary to ADHD, Vyvanse often relieves anxiety by allowing patients to control their ADHD and function better.