A recent study conducted by Rutgers Health researchers has highlighted the mixed results of using a common stimulant, lisdexamfetamine (marketed as Vyvanse), in treating binge eating disorder (BED). While many patients reported a reduction in binge episodes and improved appetite control, others experienced significant side effects and inconsistent effectiveness.
Binge Eating Disorder and Its Prevalence
Binge eating disorder is the most common eating disorder in the United States, affecting individuals across all racial and ethnic groups. Despite its high prevalence, no medication has been specifically developed or FDA-approved for the treatment of BED. This gap in treatment options led to the approval of lisdexamfetamine, a stimulant initially approved for treating attention-deficit/hyperactivity disorder (ADHD), for the treatment of BED. Lisdexamfetamine was found to reduce the frequency of binge eating episodes, and it is now the only FDA-approved medication for moderate to severe BED in adult patients.
The Study Overview
The study, which is set to appear in the December 2024 edition of Psychiatry Research Communications, examines the subjective experiences of individuals with BED who were prescribed lisdexamfetamine. The research team conducted a thematic analysis of 111 anonymous patient reviews collected from Drugs.com, an independent drug information platform. This qualitative analysis provided valuable insight into how patients perceived the medication’s effects on their condition.
Findings and Results
While some patients reported positive outcomes, including a reduction in binge episodes and improved appetite control, the study found that many others experienced side effects and inconsistent results in terms of efficacy.
Key challenges identified in the study included:
Timing of Effects:
A significant number of patients noted that their highest risk for binge eating occurred at night, while lisdexamfetamine’s appetite-suppressing effects typically wore off by the evening. This discrepancy made individuals vulnerable to nighttime binge episodes.
Side Effects:
Many patients reported experiencing a “crash” as the effects of lisdexamfetamine wore off, leading to fatigue, irritability, and mental fogginess.
Some patients attempted to adjust their dosage timing, taking the medication closer to their binge hours, but this often resulted in insomnia and other sleep disturbances.
Inconsistent Efficacy:
Patients who perceived the drug as more effective reported fewer side effects and improved focus. In contrast, those who rated the drug poorly cited concerns such as diminishing therapeutic effects, insomnia, and energy loss during the afternoon.
Lead author Abanoub Armanious, a master of science student at Rutgers School of Public Health, emphasized the significance of these findings in light of the critical gap in the treatment landscape for BED. The repositioning of lisdexamfetamine from an ADHD medication to one for BED underscores the need for targeted therapies, as no drug has been specifically developed or FDA-approved for BED, despite the disorder’s widespread prevalence both in the U.S. and globally.
Armanious stated, “The need for targeted treatment options for binge eating disorder remains a significant, unmet challenge in mental health care.”
Lisdexamfetamine’s approval for BED treatment was a significant step in addressing the disorder. Clinical trials have shown that it can effectively reduce binge eating episodes in some patients, but the variability in patient responses, as seen in this study, indicates the complexity of treating BED. These findings suggest that while lisdexamfetamine may be beneficial for some, its use is not a one-size-fits-all solution, and it may require careful monitoring and adjustment to meet individual patient needs.
The Rutgers study highlights the importance of understanding the subjective experiences of patients when evaluating the effectiveness of treatments for binge eating disorder. The researchers emphasized the need for a more nuanced approach to prescribing lisdexamfetamine and similar medications, as well as the development of new treatments with improved side effect profiles.
Morgan James, an assistant professor of psychiatry and senior author of the study, added that the ongoing work at the Rutgers Addiction Research Center focuses on finding better treatment options for BED. The development of new medications with fewer side effects is a primary goal of the research being conducted at the James Laboratory.
As the study reveals, while lisdexamfetamine may offer relief to some individuals with BED, the diverse responses underscore the need for more personalized and refined treatment approaches in addressing this common and often debilitating disorder.
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