Adderall (amphetamine) vs Vyvanse (lisdexamfetamine)
Adderall and Vyvanse, compared on what the public record actually supports: side effects by rate from each FDA label, what the largest trial comparison found, who takes each one, who pays, what the labels warn, and what the litigation record holds. Sources on every number.
the short answer
- is Adderall or Vyvanse more effective? there is no head-to-head trial record in our library that settles this pair, and we do not fill the gap with a guess. what can be compared is below: each label's own side-effect table, who takes each drug, who pays, and the legal record.
- which has fewer side effects? the labels say their trials “cannot be directly compared”, because each drug was tested in different people under different rules. what each label prints: Adderall (amphetamine): 12.0% (23/191) stopped for an adverse reaction vs 1.6% (1/64) on placebo (Adderall XR label, SPL version 38, effective 2026-04-30). Vyvanse (lisdexamfetamine): 6% (21/358) stopped for an adverse reaction vs 2% (1/62) on placebo (Vyvanse label, SPL version 81, effective 2026-04-30). the reactions both labels list, side by side, are in the table below.
- which should i take? not a question this page answers. the odds ratios are averages across thousands of strangers; your history, other medications and what you can live with are not in them. the questions for your prescriber below are built from what is on this page.
What this page will not do is rank them. These drugs are in different classes and were tested for partly different things, so a single-axis ranking would be a category error. Which one fits you turns on your history, your other medications, and side-effect trade-offs — a prescriber conversation. This page arms that conversation; here are the questions worth taking into it →
side effects by rate: what each label prints, not a head-to-head trial
the labels' own warning, first: “Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.” the two columns below come from different trials, in different people, under different inclusion rules. read each against its own placebo column, not against the other drug.
| reaction | ADDERALL XR (n=191) vs Placebo (n=64) | VYVANSE (n=358) vs Placebo (n=62) |
|---|---|---|
| nausea | 8% vs 3% | 7% vs 0% |
| dry mouth | 35% vs 5% | 26% vs 3% |
| diarrhea | 6% vs 0% | 7% vs 0% |
| insomnia | 27% vs 13% | 27% vs 8% |
| anxiety | 8% vs 5% | 6% vs 0% |
| agitation | 8% vs 5% | 3% vs 0% |
- Adderall (amphetamine): 12.0% (23/191) stopped for an adverse reaction vs 1.6% (1/64) on placebo (Adderall XR label, SPL version 38, effective 2026-04-30).
- Vyvanse (lisdexamfetamine): 6% (21/358) stopped for an adverse reaction vs 2% (1/62) on placebo (Vyvanse label, SPL version 81, effective 2026-04-30).
what makes each table, in the labels' words
- Adderall XR (amphetamine (mixed amphetamine salts)), SPL version 38, effective 2026-04-30, 6 ADVERSE REACTIONS / 6.1 Clinical Trials Experience, ADDERALL XR extended-release capsules (mixed salts of a single-entity amphetamine product: dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine sulfate, amphetamine aspartate). inclusion rule: “Reported by 5% or More of Adults Receiving ADDERALL XR with Higher Incidence than on Placebo (label Table 3 caption).” trials: “The premarketing development program for ADDERALL XR included exposures in a total of 1,315 participants in clinical trials (635 pediatric patients, 350 adolescent patients, 248 adult patients, and 82 healthy adult subjects). Adverse reactions reported in a 3-week clinical trial of children and a 4-week clinical trial in adolescents and adults, respectively, treated with ADDERALL XR or placebo are presented in the tables. Terminology note printed by the label: adverse reactions were "obtained primarily by general inquiry and recorded by clinical investigators using terminology of their own choosing … COSTART terminology has been used to classify reported adverse reactions."” DailyMed
- Vyvanse (lisdexamfetamine), SPL version 81, effective 2026-04-30, 6 ADVERSE REACTIONS / 6.1 Clinical Trials Experience, capsules and chewable tablets (one label covers both). inclusion rule: “Adverse Reactions Reported by 2% or More of Adult Patients with ADHD Taking VYVANSE and Greater than or Equal to Twice the Incidence in Patients Taking Placebo (label Table 3 caption).” trials: “The safety data in this section is based on data from the 4-week controlled parallel-group clinical studies of VYVANSE in pediatric and adult patients with ADHD. The adult table is from a single 4-week clinical trial (Study 7); the label pools the 30/50/70 mg doses in one column.” DailyMed
every row above was transcribed from the current FDA label on 2026-09-08; the full tables, including the reactions only one label lists, are on side-effect rates, drug vs placebo. the sexual side-effect rows carry each label's own underreporting caveat on the SSRI sexual side effects page.
amphetamine (Adderall)
stimulant (ADHD)
- FDA approval
- year not stated in our verified record · full approval journey →
- Who takes it (US, —)
- no survey estimate in our record
- Who pays (2024)
- no public payer series in our record
- Boxed warning
- Yes — on the current FDA label. read it in context →
- Adverse-event reports (FAERS)
- Caveat first: FAERS counts unverified REPORTS, not patients or rates — no denominator, and attention inflates reporting. Never compare these counts head-to-head; a longer-marketed, more-prescribed drug accumulates more reports by exposure alone. how to read FAERS →50,216 all-time reports; most-reported terms: drug ineffective, fatigue, nausea
- Legal & safety record
- no dedicated record page yet; the journey page carries label history
lisdexamfetamine (Vyvanse)
stimulant prodrug (ADHD)
- FDA approval
- 2007 · full approval journey →
- Who takes it (US, 2024)
- 1,619,998 patients · 9,944,999 prescriptions (AHRQ MEPS)2014 → 2024: 8,394,655 → 9,944,999 prescriptions; the change is within the survey’s margin of errorCorrection (29 September 2026): An earlier version of this section took its numbers from ClinCalc DrugStats, a third-party site that republishes this survey; we now compute them from AHRQ’s public-use files ourselves. It showed 1,604,929 people and 9,929,931 prescriptions for 2024; the file gives 1,619,998 and 9,944,999. It said prescriptions were up 18% since 2014; that change is within the survey’s margin of error, so we no longer state a direction.
- Who pays (2024)
- Medicare: 409,790 claims · 87,449 beneficiariesMedicaid: ≥3,763,488 prescriptionsCommercial claims: not published in any public dataset — a real absence, not a zero.
- Boxed warning
- Yes — on the current FDA label. read it in context →
- Adverse-event reports (FAERS)
- Caveat first: FAERS counts unverified REPORTS, not patients or rates — no denominator, and attention inflates reporting. Never compare these counts head-to-head; a longer-marketed, more-prescribed drug accumulates more reports by exposure alone. how to read FAERS →34,602 all-time reports; most-reported terms: drug ineffective, fatigue, off label use
- Legal & safety record
- no dedicated record page yet; the journey page carries label history
questions for your prescriber, built from this page
this page does not tell you to start, stop or switch anything. it arms the conversation where that decision belongs. take these in:
- which of Adderall and Vyvanse did you have in mind first, and what in my history points that way?
- these two are different classes (stimulant (ADHD); stimulant prodrug (ADHD)). what are they each being asked to do for me, and is that use on the label or off it?
- the label lists these reactions above placebo for the one you're suggesting. which of them should i expect in the first weeks, and which would make you want to hear from me the same day?
- how long were the approval trials, and what do we know past that point?
- how will we judge whether it is working, by when, and what is the plan if it isn't?
- if i ever want to come off it, how is that done, and over how long?
- is there a cheaper generic or a formulation that changes the dosing, and does my insurance prefer one of these two?
the longer checklist, for any antidepressant, is questions to ask before starting antidepressants. if you are already on one and it feels like it stopped working, that has its own page.
What the warnings mean, drug by drug
Each explainer reads one drug's current FDA label and the studies in our library, in both directions: the boxed warnings with the label's own numbers, the trials behind the approval and how long they ran, side effects by rate, and the research since.
Questions people search
Is Adderall or Vyvanse better?
No honest page can answer that in one line. Head-to-head differences between comparable psychiatric medications are usually smaller than rankings suggest, and which fits you depends on your history, other medications, and side-effect trade-offs, a prescriber conversation. What can be compared is the public record (usage, payers, label warnings, approval history, litigation), which is what this page does, with sources.
Is Adderall the same as amphetamine, and Vyvanse the same as lisdexamfetamine?
Adderall is a brand name for amphetamine. Vyvanse is a brand name for lisdexamfetamine. amphetamine is a stimulant (ADHD); lisdexamfetamine is a stimulant prodrug (ADHD). This page uses the generic names because the federal datasets do.
Which has fewer side effects, Adderall or Vyvanse?
The two FDA labels cannot be compared head to head, in their own words, because each drug's trials ran in different people under different rules. What each label prints: Adderall (amphetamine): 12.0% (23/191) stopped for an adverse reaction vs 1.6% (1/64) on placebo (Adderall XR label, SPL version 38, effective 2026-04-30). Vyvanse (lisdexamfetamine): 6% (21/358) stopped for an adverse reaction vs 2% (1/62) on placebo (Vyvanse label, SPL version 81, effective 2026-04-30). The page shows the reactions both labels list, each against its own placebo column.
Which is prescribed more, Adderall or Vyvanse?
The page shows federal survey estimates we compute from AHRQ’s Medical Expenditure Panel Survey public-use files for both amphetamine and lisdexamfetamine: patients and prescriptions in the latest reliable year, and the yearly series from 2014 where AHRQ’s reliability rule allows it, with a direction stated only when the change is larger than the survey’s margin of error. Prescription volume reflects habits, prices, and marketing as much as evidence, so it is context, not a verdict.
Where these numbers come from
- Patients and prescriptions: computed by us from AHRQ's public-use Medical Expenditure Panel Survey Prescribed Medicines files, 2014 (HC-168A) to 2024 (HC-254A), with AHRQ's reliability rule (a year with fewer than 60 respondents or a relative standard error over 50% is not shown) — counts of people filling prescriptions, not outcomes. A direction is stated only when the change is larger than the survey's margin of error. Until 29 September 2026 these came from ClinCalc DrugStats, a third-party site; see the correction under each drug where a figure changed.
- Medicare/Medicaid: CMS public datasets; commercial insurance publishes no per-drug series, so it renders as an absence, never a synthesized number.
- Label facts: the drugs' current FDA labels via DailyMed — quoted in context on each drug's approval-journey page.
- FAERS: openFDA — reports, never rates; the caveat travels above every count.
- Litigation: court records and regulator documents only, on the linked record pages; settled is never adjudicated.
Explore both drugs in depth: /m/amphetamine · /m/lisdexamfetamine · or the whole library →