Abstract
Oral lisdexamfetamine dimesylate (Vyvanse®; lisdexamfetamine), a prodrug of dextroamfetamine, is currently the only drug to be approved in the USA for the treatment of moderate to severe binge eating disorder (BED) in adult patients. Its approval was based on the results of two pivotal short-term (12 weeks) phase III studies, which showed a significantly greater reduction in binge eating days/week at the end of the study with lisdexamfetamine 50–70 mg/day than with placebo. The findings of these studies have been supported and extended by the results of longer-term (≤ 52 weeks) phase III studies, including one with a randomized 26-week withdrawal phase, which showed that lisdexamfetamine markedly reduced the risk of BED relapse relative to placebo. Lisdexamfetamine was generally well tolerated in clinical trials in patients with moderate to severe BED, with a tolerability profile similar to that observed in ADHD patients; most treatment-emergent adverse events (TEAEs) were of mild or moderate intensity. The most common TEAEs in phase III trials included dry mouth, headache and insomnia; TEAEs infrequently led to study drug discontinuation. In conclusion, lisdexamfetamine 50–70 mg/day is an effective and generally well tolerated option for treating moderate to severe BED in adults.
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During the peer review process, the manufacturer of lisdexamfetamine was also offered an opportunity to review this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.
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The preparation of this review was not supported by any external funding.
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Young-A Heo and Sean Duggan are salaried employees of Adis/Springer, are responsible for the article content and declare no relevant conflicts of interest.
Additional information about this Adis Drug Review can be found at http://www.medengine.com/Redeem/2DACF0607E38664B.
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The manuscript was reviewed by: M.C. Mancini, Obesity and Metabolic Syndrome Unit, Endocrinology and Metabolism Service, Clinics Hospital, Sao Paulo University Medical School, Sao Paulo, Brazil; J.L. Roerig, Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, ND, USA; S. Touyz, School of Psychology, University of Sydney, Sydney, Australia.
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Heo, YA., Duggan, S.T. Lisdexamfetamine: A Review in Binge Eating Disorder. CNS Drugs 31, 1015–1022 (2017). https://doi.org/10.1007/s40263-017-0477-1
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DOI: https://doi.org/10.1007/s40263-017-0477-1