Is Vyvanse (lisdexamfetamine) effective for treating food addiction?

From the Guidelines

Vyvanse (lisdexamfetamine) is recommended for the treatment of binge-eating disorder, which may be relevant to food addiction, as it helps regulate impulsive eating behaviors and reduces food cravings. 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 who prefer medication or have not responded to psychotherapy alone. The guideline recommends that patients with binge-eating disorder be treated with eating disorder-focused cognitive-behavioral therapy or interpersonal therapy, in either individual or group formats, but also suggests that medication such as lisdexamfetamine may be used as an adjunct treatment.

Key points to consider when using Vyvanse for food addiction or binge-eating disorder include:

• Starting dose: typically 30mg daily, taken in the morning
• Gradual increase: may be increased to 50-70mg daily if needed
• Treatment duration: varies but often continues for months with regular physician monitoring
• Side effects: can include insomnia, decreased appetite, anxiety, and increased heart rate and blood pressure
• Mechanism of action: regulates dopamine and norepinephrine in the brain to control impulsive eating behaviors and reduce food cravings
• Comprehensive approach: should be part of a comprehensive treatment plan including therapy, nutritional counseling, and lifestyle changes, not used alone

It is essential to note that Vyvanse is not FDA-approved for food addiction, but rather for binge-eating disorder, and its use should be carefully considered and monitored by a healthcare provider, especially in patients with certain medical conditions or a history of substance abuse 1. Regular follow-ups with healthcare providers are crucial to monitor effectiveness and manage side effects.

From the Research

Efficacy of Vyvanse for Food Addiction

• Vyvanse (lisdexamfetamine) has been approved for the treatment of moderate to severe binge eating disorder (BED) in adults 2, 3, 4.
• Studies have shown that Vyvanse significantly reduces binge eating days per week, with effect sizes ranging from 0.83 to 0.97 3, 4.
• The number needed to treat (NNT) for response to Vyvanse was 3, and the NNT for remission was 4 3.

Safety Profile of Vyvanse

• The most common treatment-emergent adverse events (TEAEs) associated with Vyvanse were dry mouth, insomnia, and headache 2, 3, 4.
• The number needed to harm (NNH) for discontinuation due to an adverse event was 44, and the NNH for common TEAEs ranged from 4 to 19 3.
• Vyvanse was generally well-tolerated, with a safety profile similar to that observed in patients with attention-deficit/hyperactivity disorder (ADHD) 2.

Combination Therapy with Cognitive Behavioral Therapy

• A randomized controlled trial found that combination therapy with cognitive behavioral therapy (CBT) and Vyvanse resulted in the largest reduction in binge eating frequency and the highest remission rate 5.
• The study suggested that CBT+Vyvanse may be a superior treatment option for BED, with significant improvements in eating disorder psychopathology and weight loss 5.

Mechanism of Action

• The exact mechanism of action of Vyvanse in treating BED is not fully understood, but it is thought to involve a combination of effects on appetite, reward, and cognitive processes, including attention and impulsivity/inhibition 6.
• Preclinical studies suggest that Vyvanse may reduce food intake, but the evidence is limited, and further studies are needed to fully understand the mechanism of action of Vyvanse in treating BED 6.