The Vyvanse Crash: Why Agitation Happens and How to Smooth It Out
Many clients who take Vyvanse for ADHD notice a shift in the late afternoon or evening that can feel uncomfortable or confusing. After a productive morning, the sudden change in mood or energy can feel like a crash. If you or your child is experiencing irritability, agitation, or emotional sensitivity as Vyvanse wears off, you are not alone. These symptoms are common and very treatable once you understand what causes them.
At Thrive for Life Counseling, we help clients navigate ADHD symptoms, medication effects, and emotional regulation every day. This blog explains why these “wear off” periods happen and what strategies can help.
What Happens When Vyvanse Wears Off
Vyvance (lisdexamfetamine) is a long acting stimulant medication often prescribed for ADHD. It typically lasts 10 to 14 hours, although this varies with age, metabolism, stress, and sleep patterns. As the medication leaves the system, many people experience what is known as a rebound effect.
Rebound happens when the brain is adjusting to a rapid drop in dopamine and norepinephrine. These neurotransmitters help with focus, motivation, emotional regulation, and impulse control. When levels fall quickly, the nervous system can temporarily swing in the opposite direction.
Common Wear Off Symptoms in the Late Afternoon or Evening
Clients frequently report:
Irritability or agitation
This is one of the most common rebound symptoms. Many describe feeling “on edge,” restless, or easily frustrated.
Emotional sensitivity
Tearfulness, overwhelm, or feeling easily hurt can increase as the medication declines.
Low energy or fatigue
After hours of improved concentration, the body may feel suddenly drained.
Return of ADHD symptoms
Distractibility, impulsivity, and difficulty concentrating often reappear quickly as medication levels fade.
Anxiety or tension
Some clients describe a “wired but tired” feeling, where the mind is restless but the body is fatigued.
Increased hunger
Appetite suppression lifts and can result in intense hunger in the evening.
These symptoms are not a sign that the medication is “wrong” or that treatment is failing. They are a predictable physiological response and can be managed with the right support.
Why Agitation Happens
Agitation is particularly common because the nervous system is adjusting from a stimulated, focused state to its baseline functioning. This shift can feel abrupt, especially for children and teens. Stress, lack of sleep, skipped meals, and dehydration can worsen agitation during this wear off window.
Understanding these patterns helps families plan for smoother afternoons and evenings.
When to Consider Medication Adjustments
If agitation or emotional crashes happen often or interfere with daily functioning, it may be useful to discuss adjustments with your prescriber. Helpful questions to explore include:
What time does the wear off typically begin
How long do symptoms last
Are symptoms emotional, physical, or both
Is the client sleeping well
Does eating a protein rich snack improve symptoms
Have stress levels increased recently
Does the return of ADHD symptoms cause conflict at home or school
Prescribers may consider changes such as:
a small dose timing adjustment
a short acting afternoon booster
lowering the morning dose
switching to a different long acting stimulant
adding a non stimulant ADHD medication
supporting sleep or nutrition patterns that reduce rebound intensity
Small changes often create meaningful improvement.
How Therapy Can Help Clients Manage Wear Off Symptoms
Therapy can support clients with:
emotional regulation skills
strategies for planning difficult times of day
parent coaching for supporting children or teens
mindfulness tools that reduce anxiety and irritability
lifestyle adjustments that improve overall stability
Understanding the internal experience behind agitation helps clients feel less ashamed or confused and more in control of their symptoms.
Support for ADHD at Thrive for Life Counseling
If you or your child is experiencing agitation or other symptoms when Vyvanse wears off, our clinicians can help you understand what is happening and create a plan to improve daily functioning. ADHD treatment works best when medication support and emotional support work together.
Thrive for Life Counseling offers virtual counseling across several states and provides evidence based care for ADHD, anxiety, depression, and emotional regulation.
Connect with us today to schedule an appointment.
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