From the Guidelines
Vyvanse (lisdexamfetamine) is recommended over SSRIs for the treatment of binge eating disorder due to its FDA approval and efficacy in regulating impulsive eating behaviors, as suggested by the American Psychiatric Association practice guideline for the treatment of patients with eating disorders 1. When considering treatment options for binge eating disorder, it's essential to weigh the benefits and harms of each medication.
- Vyvanse, specifically, has been suggested for adults with binge-eating disorder who prefer medication or have not responded to psychotherapy alone, as stated in the APA guideline 1.
- The APA recommends eating disorder-focused cognitive-behavioral therapy or interpersonal therapy as the primary treatment for patients with binge-eating disorder, with medication considered for those who prefer it or have not responded to therapy alone 1. Key considerations for using Vyvanse include its potential side effects, such as increased heart rate and blood pressure, and the risk of misuse.
- In contrast, SSRIs like fluoxetine may be used off-label for binge eating disorder, particularly when co-occurring with depression or anxiety, but they carry their own set of side effects, including sexual dysfunction and initial GI distress. The choice between Vyvanse and SSRIs should be individualized, taking into account comorbid conditions, side effect profiles, and prior medication responses.
- Ultimately, both medications should be part of a comprehensive treatment plan that includes psychological therapy to address the underlying psychological aspects of binge eating disorder, as emphasized by the APA guideline 1.
From the FDA Drug Label
Lisdexamfetamine Dimesylate Capsules are indicated for the treatment of: ... Moderate to severe binge eating disorder (BED) in adults 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.
Vyvanse (lisdexamfetamine) is indicated for the treatment of moderate to severe binge eating disorder (BED) in adults. The recommended dosage is 30 mg once daily, titrated to a target dose of 50 mg to 70 mg once daily.
- Key points:
- Vyvanse is approved for BED treatment
- Initial dose: 30 mg once daily
- Target dose: 50 mg to 70 mg once daily There is no information in the provided drug label about using SSRI for binge eating disorder treatment 2.
From the Research
Treatment Options for Binge Eating Disorder
- Binge eating disorder (BED) is a serious eating disorder that can have significant consequences on a person's physical and mental health.
- There are several treatment options available for BED, including medications and therapy.
Medications for Binge Eating Disorder
- Lisdexamfetamine (Vyvanse) is a medication that has been approved by the FDA for the treatment of moderate to severe BED in adults 3, 4, 5, 6.
- Studies have shown that lisdexamfetamine can significantly reduce the number of binge eating days per week and improve symptoms of BED 3, 4, 5, 6.
- The recommended dose of lisdexamfetamine for BED is 50-70 mg/day 3, 6.
- Common side effects of lisdexamfetamine include dry mouth, decreased appetite, insomnia, and headache 3, 6.
Comparison with SSRIs
- Selective serotonin reuptake inhibitors (SSRIs) are a type of medication that is commonly used to treat depression and other mental health conditions.
- While SSRIs have been used to treat BED, there is limited evidence to support their effectiveness for this condition 7.
- Lisdexamfetamine has been shown to be more effective than placebo in reducing symptoms of BED, and may be a more effective treatment option than SSRIs for some people 3, 4, 5, 6.
Efficacy and Safety of Lisdexamfetamine
- Studies have shown that lisdexamfetamine is generally well-tolerated and effective in reducing symptoms of BED 3, 4, 5, 6.
- The number needed to treat (NNT) for lisdexamfetamine is 3-4, indicating that 3-4 people need to be treated with the medication in order for one person to experience a significant reduction in symptoms 6.
- The number needed to harm (NNH) for lisdexamfetamine is 44, indicating that 44 people need to be treated with the medication in order for one person to experience a significant side effect 6.