Exploring Bi-Directional Impacts of Lisdexamfetamine Dimesylate on Psychological Comorbidities and Quality of Life in People with Binge Eating Disorder

Lisdexamfetamine dimesylate (LDX) has demonstrated safety and efficacy for treatment of Binge Eating Disorder (BED). However, to date, trials have not included participants with co-occurring psychiatric disorders. This study explores how LDX affects eating disorder psychopathology, symptoms of common psychiatric comorbidities of BED (ADHD, depression, anxiety), and psychological quality of life, in people with moderate to severe BED. These are secondary analyses of an open-label LDX trial conducted in 41 adults (18–40 years) over eight-weeks. Participants received LDX titrated to 50 or 70 mg. Clinical assessments and self-report questionnaires were conducted at baseline and 8-week follow-up. Eating disorder psychopathology and psychological quality of life improved after 8-weeks of LDX. No significant group-level changes in depression, anxiety or ADHD severity scores were observed. However, the majority within the small subsets with elevated depression and ADHD symptoms experienced reduced depressive and inattentive symptom severity, respectively. We provide proof-of-concept evidence that LDX may provide broader psychological benefits to individuals with BED, beyond reducing their BE frequency. Effects of LDX on anxiety should be monitored closely by clinicians. Early indications suggest that LDX may be effectively used in people with BED, with and without co-occurring psychiatric conditions, however tolerability may be lower in highly complex cases. Trial registration: Australian and New Zealand Clinical Trials Registry (anzctr.org.au) #ACTRN12618000623291. Lisdexamfetamine dimesylate (LDX) has been shown to reduce binge eating frequency among those with Binge Eating Disorder (BED). However, little is known about how LDX affects symptoms of common co-occurring conditions (ADHD, depression, anxiety) and mental health more broadly. In this study, 41 people with BED received an 8-week course of LDX and their symptoms were monitored before and after treatment. Overall, people experienced a robust improvement in eating disorder psychopathology and psychological quality of life. For those with higher levels of depression and ADHD, LDX had the additional benefit of improving depressive symptoms and inattentive symptom severity, respectively. The effect of LDX on anxiety symptoms appears to be more complex, with an equal proportion of people experiencing a decrease or an increase in anxiety over the course of treatment. Those who experienced reductions in anxiety during treatment tended to have greater concurrent reductions in binge eating frequency. This study provides preliminary evidence that for people with BED, LDX may be effective at improving co-occurring symptoms of eating disorder psychopathology and psychological well-being, and potentially ADHD and depression symptoms when present at an elevated level. More research is needed among a larger sample to verify these findings.