Lisdexamfetamine: a prodrug stimulant for ADHD

This article reviews the unique prodrug stimulant lisdexamfetamine dimesylate (LDX, Vyvanse), an approved treatment for attention-deficit/hyperactivity disorder. LDX is an inactive prodrug in which l-lysine is chemically bonded to d-amphetamine. Although its efficacy is not significantly different from that of other stimulants, LDX may be different with respect to potential toxicity and abuse liability. In this article, I will review the short-term controlled studies that were the basis for LDX's approval for both children and adults; the lack of and need for more long-term studies; two double-blind, placebo-controlled, crossover studies that examined LDX's abuse liability; and clinical uses for the drug. The clinical implications stemming from LDX's unique characteristics are also discussed.