Interaction of Vyvanse With Alcohol

It’s a typical Saturday night. You’re at your favorite Japanese restaurant, and when the waiter comes to take your order, you rattle off, “Miso salmon, a side of broccoli and rice, and a glass of …” You’re about to order your usual red, but then you remember that you’re taking Vyvanse — a medication commonly prescribed for attention-deficit/hyperactivity disorder (ADHD). Can you drink on Vyvanse? Is drinking on Vyvanse dangerous? Let’s explore!

What Is ADHD?

Attention deficit and hyperactivity disorder (ADHD) is a familiar term today, but what does it mean? In The Lightning Thief, Rick Riordan describes it as a superpower: “Taken together, it’s almost a sure sign. The letters float off the page when we read, right? That’s because your mind is hardwired for ancient Greek. And the ADHD — we’re impulsive, can’t sit still in the classroom. That’s your battlefield reflexes. In a real fight, they’d keep you alive. As for the attention problems, that’s because you see too much, Percy, not too little. Your senses are better than a regular mortal’s.”

While this way of seeing ADHD is refreshingly optimistic, the condition actually can be a burden. Those with ADHD daydream, unintentionally interrupt others when a sudden idea strikes, fidget with their hair or phone, and leave the laundry they’re folding half-done to reorganize the kitchen cupboards. You get the picture — ADHD can get in the way of living for children and adults alike.

From a neuroscience perspective, the problems with attention are the result of a communication glitch between the decision-making prefrontal cortex and the striatum, which is involved in attention. So, as we can see, the term “attention deficit” is a bit of a misnomer: there’s no “lack” of attention; we just focus on the “wrong” thing. The hyperactivity part, in turn, has more to do with differences in the dopamine-driven reward system that makes it difficult for people with ADHD to stay motivated without external stimulation. 

The use of medication to treat the symptoms of ADHD remains somewhat controversial, but for many, medication has proved effective in easing the symptoms.

What Is Vyvanse?

Historically, the first line of medication treatment for ADHD comprise stimulants — drugs that speed up the nervous system, such as Adderall and Ritalin. While generally sanctioned by the medical community as a viable solution for some, a major source of concern with stimulants has been the risk of dependency. As a result, the FDA regulates them with gusto (and with good reason —  there have been many cases of addiction, overdose, and even death caused by stimulants over the years).

Enter Vyvanse. Unlike other stimulants, Vyvanse is a prodrug, which means it only becomes active once it's gradually metabolized by the body. The result? It has the effects of other stimulants but potentially reduces abuse risk since it doesn’t provide the same energy boost that many find so enticing (and ultimately counterproductive).

Can We Drink on Vyvanse?

But what about drinking on Vyvanse? As it turns out, we’re better off opting out to avoid some unpleasant surprises. Let’s explore why mixing Vyvanse and alcohol isn’t a good idea.

1. Vyvanse and Alcohol: Speeding Up the Side Effects

First of all, there’s the issue of side effects, many of which can be amped up by alcohol. According to Drugs.com, common Vyvanse side effects include the typical ones we would expect from stimulants:

• Dry mouth. Alcohol can make Vyvanse-related dry mouth worse by causing dehydration. Yes, it’s a liquid, but it’s a sneaky one: booze suppresses vasopressin, a hormone that tells our kidneys to retain water. The result? We lose too much water and wake up parched the next morning.
• Sleep problems. This is a big one when it comes to alcohol. While a glass or two of wine might make us doze off, don’t be fooled: the sleep we end up getting is likely to be disrupted by frequent bathroom trips as well as by a rebound surge of neurochemicals the brain releases to counteract the initial depressant effect. Plus, we end up missing out on the restorative REM stage of sleep. Together with insomnia caused by Vyvsnse, we are headed for one groggy morning.
• Fast heart rate and jittery sensation. Arguably the biggest red flag when it comes to the Vyvanse–alcohol combo (at least on the physical side of things) is heart rate fluctuation. Alcohol can increase heart rate, cause arrhythmia, and even lead to serious heart disease.
• Anxiety and irritability. Feeling on edge after taking Vyvanse? Alcohol could make it worse. In addition to causing next-day “hangxiety,” alcohol disrupts our neurotransmitter balance, making us more prone to bouts of sadness, angry outbursts, and mood swings.
• Loss of appetite and weight loss. Like many other stimulants, Vyvanse puts food on our brain’s back burner — sometimes to the point that it becomes a problem. Meanwhile, alcohol tends to do the opposite (midnight dumplings or pizza, anyone?). Combine Vyvanse and undereating during the day with alcohol’s prompting to load up on greasy late-night snacks, and we’re headed for a bumpy night.
• Gastrointestinal side effects. Vyvanse can cause nausea, vomiting, stomach pain, diarrhea, and constipation. Alcohol can lead to all of the above, so combining the two is asking for double the trouble.

As we can see, the side effects of Vyvanse and alcohol don’t mix well. But there are other reasons why it’s wise to avoid the combination.

2. Stimulants and Alcohol: A Dangerous Mix

As a stimulant, Vyvanse increases neurotransmitter activity in the brain, which can boost energy and alertness. When we mix it with booze — a depressant — two not-so great things happen:

• The combination is extra tough on the heart. We mentioned that cardiovascular side effects (such as increased heart rate) come with both Vyvanse and alcohol and could be troublesome when we mix the two substances together. There’s also extra strain from the conflicting effects, however. As a depressant, alcohol slows down the central nervous system and leads to an initial drop in blood pressure (after which we sometimes experience the rebound effect of high heart rate and blood pressure spikes). 
• The “masking effect” leads us to drink more. With Vyvanse giving us an extra boost of energy, the so-called “masking effect” makes it harder to tell how intoxicated we really are. This is the reason why mixing caffeine and booze is also a bad idea: the combination can lead us to overdo it, possibly to the point of heavy intoxication or even alcohol poisoning.

Our heart does a lot of work for us every second of our lives. Let’s give it the care it deserves (while also avoiding the pitfalls of the masking effect). The risk just isn’t worth it.

3. Alcohol and Vyvanse: Dependency Risk

One of the most serious risks of mixing Vyvanse and alcohol is the risk of dependency. While the risk is lower than it is in fast-acting drugs such as Adderall, Vyvanse still causes dopamine release. Since alcohol does the same — and since artificial dopamine boosts can cause unnatural spikes in feelings of reward and pleasure — we can find ourselves at risk of addiction and substance misuse.

Moreover, alcohol can lower inhibitions and impair judgment — a concern significant for those of us dealing with ADHD. The combination with Vyvanse might lead to increased impulsivity and poor decision making, resulting in risky behaviors.

4. ADHD and Alcohol

When it comes to ADHD symptoms, alcohol is counterproductive, to say the least. Anyone who has tried to have a focused conversation with a friend who’s had a few too many knows how it’s often a lost cause. Likewise, trying to get a tipsy group of people to go somewhere together can feel like herding cats: their attention spans get worse by the minute, and their ability to focus can seem virtually nonexistent. 

By slowing down activity in the prefrontal cortex, alcohol gets in the way of our ability to think logically and stay focused. Moreover, it tends to lead to so-called “alcohol myopia” — a tendency to focus on the most salient (i.e., “juiciest”) aspect of a subject or scene while ignoring everything else. This tendency to hyperfocus on whatever grabs our attention is exactly what we’re already fighting against if we have ADHD. The whole point of taking medications such as Vyvanse is to put the prefrontal cortex back in the driver’s seat — and alcohol makes that harder.

How Long After Vyvanse Can I Drink Alcohol?

Perhaps you’re thinking, “How long after taking Vyvanse can I drink alcohol?” According to scientists and doctors, the best approach is to avoid alcohol completely while you’re on Vyvanse. You will eliminate the risk of adverse interactions and set yourself up for success when it comes to managing your symptoms.

That said, if you do choose to drink, healthcare providers advise waiting at least 14 hours, which is about how long Vyvanse is active. However, everyone is different, so give it a bit more time if you are still feeling the effects. And, most importantly, always ask your doctor if you have questions!

Tips To Stay Safe

Finally, here are some tips to stay safe on Vyvanse,

1. Avoid the mix. Take a break from alcohol while you’re on Vyvanse — it’s not worth the risk!

2. Nourish your body. Even if you don’t feel as hungry as usual, make sure to fuel your body with enough proteins, whole grains, healthy fats, fruits, and vegetables. Your brain (as well as the rest of your body) needs the right nutrients to function at its best.

3. Hydrate. Water is just as important — keep a water bottle around throughout the day and add some electrolyte powder mix if you don’t like the taste.
4. Get your rest. Just like food, sleep is essential — even if it seems like you need less of it on Vyvanse. Aim for at least 7-9 hours a day, and make sure your sleep environment is free of distractions.
5. Build your toolbox. While medications like Vyvanse can work as long-term solutions for some peole, for others they cannot. In that case, it’s helpful to have on hand other reliable tools for managing ADHD. Many people find that behavioral therapy (such as CBT) can be a powerful asset, either as a stand-alone or add-on to pharmaceutical treatment. Mindfulness and meditation-based techniques can also work wonders when it comes to improving attention and focus.

With these tips, you can get the most out of your treatment while staying safe.

Summing Up

In the end, it’s all about balance and doing what’s best for your body and mind. Your doctor prescribes certain medications for a reason, so work with them to chart the best course of treatment and how to go about it. In the meantime, if you’re having trouble staying away from alcohol, Reframe is here to help!