Maintenance lisdexamfetamine shows promise in binge-eating disorder treatment

Adults with binge-eating disorder and obesity who responded to acute lisdexamfetamine (LDX) treatment demonstrate sustained benefits during the subsequent 12-week maintenance phase, with better eating-disorder psychopathology outcomes and greater weight-loss relative to placebo, as shown in a study.

The prospective, single-site, randomized double-blind placebo-controlled trial included 61 patients (mean age 44.3 years, 83.6 percent women) with binge-eating disorder and obesity (mean BMI 36.1 kg/m²) who had response to acute treatments with LDX alone or in combination with cognitive-behavioural therapy (CBT + LDX). These patients were randomly assigned to receive maintenance treatment with either LDX (n=32) or placebo (n=29) for 12 weeks.

Mixed-models and generalized-estimating equations were used in the analyses.

The majority of the patients (95.1 percent) completed post-treatment assessments. Following the 12-week maintenance period, relapse rates (diagnosis-level binge-eating frequency) were 10.0 percent with LDX and 17.9 percent with placebo. The intention-to-treat binge-eating remission rates were 59.4 percent and 65.5 percent, respectively.

Binge-eating frequency did not differ between the maintenance LDX and placebo groups. However, weight-loss and eating-disorder psychopathology outcomes were better in the maintenance LDX group. Specifically, maintenance LDX was associated with weight loss of 2.3 percent whereas placebo was associated with weight gain of 2.2 percent. Weight-change throughout treatment and at post-treatment differed significantly between the two treatment groups in favour of LDX. Meanwhile, eating-disorder psychopathology remained unchanged in the maintenance LDX group but increased significantly in the placebo group.

Acute treatments did not significantly predict or moderate maintenance-treatment outcomes.