Could Binge Eating Disorder Be Treated with ADHD Medication?
A drug currently approved for attention deficit hyperactivity disorder (ADHD) may offer hope for people struggling with binge-eating disorder. Binge-eating disorder affects about 3 percent of Americans and can lead to health problems tied to obesity.
According to a recent clinical trial, the ADHD drug lisdexamfetamine dimesylate (Vyvanse) reduced binge eating in patients with moderate to severe binge-eating disorder. This opens up another potential treatment option for people with the disorder. Patients often face insatiable cravings for food accompanied by feelings of shame.
“Binge-eating disorder is a serious mental disorder associated with distress, psychiatric symptoms, reduced quality of life, and disability, and for which treatments are greatly needed,” said study author Dr. Susan L. McElroy, a professor of psychiatry and neuroscience at the University of Cincinnati College of Medicine.
Patients with Binge-Eating Disorder Are Often Under-Treated
In the study, published online in JAMA Psychiatry, researchers randomly assigned about 250 volunteers to take either Vyvanse or a placebo pill for 11 weeks. People taking Vyvanse received a dose of 30, 50 or 70 milligrams per day.
By the eleventh week, the ADHD drug had reduced the number of days per week that people had a binge-eating episode, but only if they were taking one of the two higher doses. The percentage of people who stopped binge eating by the fourth week of the study was also higher in the group taking 50 or 70 milligrams per day of Vyvanse, compared to the placebo group.
Binge eating is associated with several other health problems, including depression, obesity, type 2 diabetes, and heart disease. Current treatments for binge-eating disorder include cognitive behavioral therapy and interpersonal psychotherapy.
Therapy can reduce binge-eating behavior, but not all patients respond well to these techniques. So, many people with binge-eating disorder are under-treated, and the condition continues to cause problems in their personal and social lives.
The U.S. Food and Drug Administration (FDA) has not approved any drug treatments for binge-eating disorder. Other drugs have been prescribed for these patients with mixed results. Antidepressants can reduce the frequency of binge eating, but they may not help people lose weight. Likewise, the anticonvulsant topiramate (Topamax) may help, but this drug has serious side effects, especially on thinking skills.
Doctors think binge eating is caused by a problem with the brain chemicals dopamine and norepinephrine. Eating food causes an abnormal dopamine response in the brain. Vyvanse may work by balancing how the brain uses dopamine in order to reduce food cravings.
Benefits of Vyvanse May Outweigh Its Side Effects
The current study was small and the results may not apply to every group of people with the disorder. In particular, the study included only white women. Volunteers with existing heart or psychiatric conditions were kept out of the study.
Vyvanse also has potentially serious side effects, including drowsiness or dizziness, heart attack or stroke, and behavioral changes, such as aggression, hostility, or suicidal thinking. The medication is a controlled substance in the same class as morphine and amphetamine, with the potential for abuse and dependence.
“In this study, the adverse event profile associated with [Vyvanse] was similar to that seen in people with ADHD who are treated with the drug,” said McElroy. “Further studies on the safety and effectiveness in binge-eating disorder are ongoing.”
Before Vyvanse can be prescribed for binge-eating disorder it will need to undergo further clinical testing and be approved by the FDA. The researchers are hopeful that the drug will offer a way forward for people with the eating disorder.