From the Guidelines
Vyvanse (lisdexamfetamine) is a recommended treatment option for adults with binge-eating disorder who prefer medication or have not responded to psychotherapy alone. According to the American Psychiatric Association practice guideline for the treatment of patients with eating disorders 1, lisdexamfetamine is suggested as a treatment option for adults with binge-eating disorder. The guideline recommends eating disorder-focused cognitive-behavioral therapy or interpersonal therapy as the first line of treatment, but suggests that adults who prefer medication or have not responded to psychotherapy alone may be treated with either an antidepressant medication or lisdexamfetamine.
Key points to consider when prescribing Vyvanse for binge-eating disorder include:
- Starting dose: typically 30mg once daily in the morning
- Potential increases: up to 70mg daily as needed
- Treatment duration: individualized, but clinical trials have demonstrated effectiveness over 12-week periods
- Mechanism of action: regulates dopamine and norepinephrine in the brain to control impulsive eating behaviors and reduce binge eating episodes
- Common side effects: dry mouth, insomnia, decreased appetite, anxiety, and increased heart rate or blood pressure
- Potential for abuse: requires careful monitoring, especially in patients with a history of substance abuse
- Contraindications: cardiovascular conditions, hyperthyroidism, glaucoma, or concomitant use of MAO inhibitors
It is essential to weigh the benefits and harms of treatment with Vyvanse, considering the individual patient's values and preferences, as well as their medical history and potential for substance abuse 1.
From the FDA Drug Label
Lisdexamfetamine Dimesylate Capsules are indicated for the treatment of: ... Moderate to severe binge eating disorder (BED) in adults [see Clinical Studies (14.2)]. The recommended starting dosage in adults is 30 mg once daily to be titrated in increments of 20 mg at approximately weekly intervals to achieve the recommended target dose of 50 mg to 70 mg once daily. Lisdexamfetamine dimesylate capsules may help reduce the number of binge eating days in people with BED.
Vyvanse (lisdexamfetamine) is effective for treating binge eating disorder in adults. The recommended dosage is 30 mg once daily, titrated to a target dose of 50 mg to 70 mg once daily 2.
From the Research
Efficacy of Vyvanse for Binge Eating Disorder
- Vyvanse (lisdexamfetamine) is currently the only drug approved in the USA for the treatment of moderate to severe binge eating disorder (BED) in adult patients 3.
- Studies have shown that lisdexamfetamine significantly reduces binge eating days/week at the end of the study compared to placebo 3, 4.
- Lisdexamfetamine has been found to be effective in reducing the risk of BED relapse relative to placebo in longer-term studies 3.
Safety and Tolerability of Vyvanse for Binge Eating Disorder
- Lisdexamfetamine is generally well tolerated in clinical trials in patients with moderate to severe BED, with a tolerability profile similar to that observed in ADHD patients 3.
- The most common treatment-emergent adverse events (TEAEs) in phase III trials included dry mouth, headache, and insomnia 3.
- TEAEs infrequently led to study drug discontinuation 3.
Comparison with Other Treatments for Binge Eating Disorder
- Lisdexamfetamine, second-generation antidepressants, and cognitive behavioral therapy have been found to be effective in reducing binge-eating frequency and increasing binge-eating abstinence 4.
- Lisdexamfetamine and topiramate have been found to reduce weight and increase sympathetic nervous system arousal in adults with BED 4.
- Other forms of cognitive behavioral therapy and topiramate have also been found to increase abstinence and reduce binge-eating frequency and related psychopathology 4.
Clinical Considerations for Using Vyvanse to Treat Binge Eating Disorder
- Lisdexamfetamine is currently the only medication approved by the US Food and Drug Administration for the treatment of BED 5, 6.
- Effect sizes for lisdexamfetamine versus placebo for response, remission, and avoidance of relapse in BED are robust, but its use may be limited by tolerability 6.
- Additional medication choices approved by the US Food and Drug Administration for the treatment of BED are needed 6.