Actually ADHD | Medication Strategies & Clinical Wisdom
Jul 25, 2026 · 14 min · 14 segments
Why Vyvanse became the internet's favorite ADHD medication and what patients and prescribers should actually understand about it. Jonathan Murphy, PMHNP-BC, walks through the pharmacology, the…
Jonathan MurphyHost

So today I'm going to talk about what Vyvanse is, how to think about it, and why.

So as I've talked about in the past, as long as we're excluding the non-stimulant options and we're only talking about ADHD stimulant medications, which is going to account for the vast majority of effective first-line ADHD medications, we're talking about two separate chemicals, amphetamine and methylphenidate.

And now we have ADHD, which does a very good job of identifying the subset of people who will actually benefit from the medicine.

We're talking about therapeutic application of these medications for a particular individual.

which just so happens to make up a subset of the population, a subset of humanity.

Because yes, this phenomenon has been documented before the medicine was around.

And the medicine was discovered before the appropriate application was found.

It wasn't until around the year 2000, we got the extended release formulations, which really allowed to improve toleration because it allows the body to absorb the medication in a gentle way.

And from there, it's dialing in the individual amount of stimulation for each adult with ADHD.

Just a reminder, I'm talking about adults with ADHD, the kids from the 80s and 90s that grew up.

In pediatrics, while I did treat children and adolescents for some time, I'm not going to speak on that population because I feel they required completely distinctive treatment approaches.

So 95% of the time or more, you're going to land on an extended release stimulant medication as first line, most effective, the most safe, and the hopeful outcome of all good, no bad.

We're looking at the extended release stimulant medications, methylphenidate and amphetamine, the two most well-known brand names.


So today I'm going to talk about what Vyvanse is, how to think about it, and why.

So as I've talked about in the past, as long as we're excluding the non-stimulant options and we're only talking about ADHD stimulant medications, which is going to account for the vast majority of effective first-line ADHD medications, we're talking about two separate chemicals, amphetamine and methylphenidate.

And now we have ADHD, which does a very good job of identifying the subset of people who will actually benefit from the medicine.

We're talking about therapeutic application of these medications for a particular individual.

which just so happens to make up a subset of the population, a subset of humanity.

Because yes, this phenomenon has been documented before the medicine was around.

And the medicine was discovered before the appropriate application was found.

It wasn't until around the year 2000, we got the extended release formulations, which really allowed to improve toleration because it allows the body to absorb the medication in a gentle way.

And from there, it's dialing in the individual amount of stimulation for each adult with ADHD.

Just a reminder, I'm talking about adults with ADHD, the kids from the 80s and 90s that grew up.

In pediatrics, while I did treat children and adolescents for some time, I'm not going to speak on that population because I feel they required completely distinctive treatment approaches.

So 95% of the time or more, you're going to land on an extended release stimulant medication as first line, most effective, the most safe, and the hopeful outcome of all good, no bad.

We're looking at the extended release stimulant medications, methylphenidate and amphetamine, the two most well-known brand names.
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