Thursday, December 04, 2008


Below is my response to a post on Dr. Dan Carlat's Psychiatry blog.

Here is the original story,
Why Americans Hate Pharma Almost As Much As They Hate Oil Companies: the Case of Cephalon

Disclosure: I am a speaker for Shire (Vyvanse).

I would take objection to the assertion that Vyvanse is not much of an improvement over Adderall XR. Briefly, there are many areas in which, both in study data and in my clinical experience, Vyvanse offers significant advantages over Adderall XR:

1. As a prodrug, it is true that abusability is greatly reduced. This is a significant advance.

2. Duration of action is greatly improved from an average of 8 hours (XR) to 12-13 hours. I had a lot of XR patients who were also taking Adderall tablets in the afternoon to keep them from crashing, and this is not necessary with Vyvanse.

3. Consistency of action is much improved. With XR, I had a lot of patients who swore it only lasted 4 hours - the second bead didn't kick in, or else kicked in too soon. You get a lot more smoothness and better patient-to-patient reliability with Vyvanse.

I do agree that Pharma has issues with patent games, isomers, metabolites, etc. There's still plenty of cynic in me - I haven't drunk all the corporate Kool-Aid. However, picking Shire as an example in the original story really wasn't that fair, as you sort of pointed out, Dan.

Keep up the good work, and I'll keep reading. Cheers!

J.P. Swing MD
Fredericksburg, VA

1 comment:

St_PatGuy said...

Are you creating some kind of tax loop for yourself with this one???