A drug that has been used to treat ADHD may also be effective at treating binge eating disorder, according to a new study published in the journal JAMA Psychiatry.
The drug in question is known as lisdexamfetamine dimesylate, which has been on the market to treat ADHD since 2007 under the brand name Vyvanse. It is also being studied as a possible treatment for major depressive disorder, daytime sleepiness and certain symptoms of schizophrenia.
The results from the new study provide evidence that this drug could be part of an effective treatment plan for binge eating disorder (BED). A drug known as topiramate has also been tested as a treatment for BED and other eating disorders, but it is associated with a number of serious side effects. In contrast, the results from this study of lisdexamfetamine dimesylate suggest that using the drug to treat BED involves the same range of mild possible side effects that ADHD patients experience with Vyvanse.
Like ADHD patients, people with BED typically experience dysfunction in their reward control systems, which results in highly impulsive behavior. This drug affects the norepinephrine and dopamine systems of the brain, helping patients to remain focused on tasks and goals and feel more in control of their impulses. For people with BED, the drug appears to give them more control over their reward-seeking and episodes of rapid overeating.
FDA Backs Drug for BED Treatment
For the second phase of this study, a group of 270 patients with BED were randomly selected to receive fixed doses of 30 mg, 50 mg or 70 mg of lisdexamfetamine dimesylate. The results showed that patients who received 50 mg or 70 mg of the drug had 0.3 and 0.1 binge days per week respectively, compared to 1.1 binge days for patients on the placebo. Patients who received only 30 mg had results similar to those taking the placebo.
In January 2015, after reviewing the data from this study—which included a previous phase I trial followed by the most recent phase II trial—the Food and Drug Administration expanded the approved uses of Vyvanse to treat BED in adults. It is the first medication that has received FDA approval to treat this condition.
Psychotherapy, Cognitive Behavioral Therapy Also Effective
Medication is not the only possible treatment for binge eating disorder; in fact, psychotherapy and cognitive behavioral therapy have been found to be very effective for many patients with BED. However, a wide range of treatment options can help to ensure that as many patients as possible receive effective help using one or more of the available options.
This study did not explore the relative effectiveness of the drug, psychotherapy and cognitive behavioral therapy. Instead, this study explored only whether lisdexamfetamine dimesylate was more effective for BED patients than a placebo. Future research that does directly compare these treatment methods will help treatment professionals determine which approach (or combination of approaches) becomes the preferred, go-to method and which methods are deferred for cases in which the go-to option is not effective.
Another avenue for future research is an examination of how well the effects of the drug last throughout the night. Nighttime is when many binge eating episodes occur for a large number of patients. This question was not particularly relevant for patients with ADHD, who want the drug to be effective during the daytime when they are active and engaged in various tasks.
The pharmaceutical company Shire, which manufactures Vyvanse, provided the funding for this study.