The Medical Letter on Drugs and Therapeutics
In Brief: Lisdexamfetamine (Vyvanse) for Binge Eating Disorder
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Lisdexamfetamine dimesylate (Vyvanse), a prodrug of dextroamphetamine previously approved for treatment of attention-deficit/hyperactivity disorder, has now been approved for treatment of moderate-to-severe binge eating disorder (recurrent episodes of compulsive overeating without purging) in adults.

FDA approval of lisdexamfetamine for this indication was based on two unpublished, 12-week trials, summarized in the package insert, that randomized patients with moderate-to-severe binge eating disorder to lisdexamfetamine 30 mg/day, which was titrated to 50 mg or, if needed, 70 mg, or to placebo. In both studies, patients treated with the active drug had a significantly greater reduction from baseline in binge days/week than those treated with placebo. In the first study (n=374), the placebo-subtracted difference was 1.35 binge days/week. In the second study (n=350), the difference was 1.66 binge days/week.

The recommended dosage of lisdexamfetamine for treatment of binge eating disorder is 30 mg/day, which can be titrated in 20-mg increments per week to a maximum of 70 mg/day. The cost of 30 days' treatment is about $217.1

Patients with eating disorders have an increased risk of overuse of stimulants for weight loss. The long-term effectiveness and safety of lisdexamfetamine in this population remain to be determined.

  1. Approximate WAC. WAC = wholesaler acquisition cost or manufacturer’s published price to wholesalers; WAC represents a published catalogue or list price and may not represent an actual transactional price. Source: AnalySource® Monthly. March 5, 2015. Reprinted with permission by First Databank, Inc. All rights reserved. ©2015.
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