Male, 54, no prior urinary issues ever. Started noticing trouble urinating a few months into treatment, worse as the dose increased. Symptoms:

\- Weak, hesitant stream that comes in two "phases"

\- Have to actively use abdominal/pelvic pressure to void

\- Waking up to pee 3-4 times a night, which is completely new for me

\- No pain, no blood

I've had a full urological workup: clean urinalysis, normal PSA, normal kidney function, normal digital prostate exam. Everything structural checks out. Lisdexamfetamine is the only new medication in my life, and my doctor is now looking into whether it could be the cause — she'd never heard of this specific side effect before, which is part of why I'm asking here.

For context: the drug is a sympathomimetic, and the bladder neck/internal sphincter is rich in alpha-1 receptors, so there's a plausible mechanism (same reason older amphetamines were sometimes used for bedwetting). Atomoxetine has this listed as a known side effect in some markets; lisdexamfetamine less commonly discussed, but I'm wondering if it's underreported rather than rare.

Has anyone else on lisdexamfetamine (or dexamfetamine) noticed anything similar? Curious whether it's dose-dependent for others too, and whether anyone found a workaround (dose timing, adding an alpha-blocker, switching meds) that let them stay on it. It's genuinely the best ADHD medication I've tried and I'd like to find a way to keep it if possible.

Lisdexamfetamine (Elvanse/Vyvanse) and urinary hesitancy/retention — anyone else?