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. 2024 Jun 13;12(1):80.
doi: 10.1186/s40337-024-01041-9.

Exploring bi-directional impacts of Lisdexamfetamine dimesylate on psychological comorbidities and quality of life in people with Binge Eating Disorder

Kristi R Griffiths  1   2 , Stephanie Boulet  3 , Sarah Barakat  3 , Stephen Touyz  3   4 , Phillipa Hay  5 , Sarah Maguire  3 , Michael R Kohn  6   5   7   8
Affiliations

Exploring bi-directional impacts of Lisdexamfetamine dimesylate on psychological comorbidities and quality of life in people with Binge Eating Disorder

Kristi R Griffiths et al. J Eat Disord. .

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: ADHD; Anxiety; Depression; Medication; Mental Health; Pharmacotherapy; Psychopharmacology.

Plain language summary

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.

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Conflict of interest statement

PH receives/has received sessional fees and lecture fees from the Australian Medical Council, Therapeutic Guidelines publication, and HETI (New South Wales and the former NSW Institute of Psychiatry) and royalties/honoraria from Hogrefe and Huber, McGraw Hill Education, and Blackwell Scientific Publications, Biomed Central and PlosMedicine. She is Chair of the National Eating Disorders Collaboration Steering Committee in Australia (2019-) and was Member of the ICD-11 Working Group for Eating Disorders and was Chair Clinical Practice Guidelines Project Working Group (Eating Disorders) of RANZCP (2012–2015). She is a consultant to Takeda Pharmaceuticals. All views in this paper are her own. ST has been the recipient of honoraria from Shire (Takeda group of companies) for public speaking engagements and commissioned reports. He has been the Chair of their Clinical Advisory Group for Binge Eating Disorder. MRK has been the recipient of honoraria from Shire (Takeda group of companies) for public speaking engagements. SM was a one time recipient of Honoraria from Shire (Takeda) for a single public speaking engagement on an unrelated subject matter. All other authors have no potential conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
CONSORT participant flow diagram
Fig. 2
Fig. 2
Corset plots showing individual changes and distributions of each of the primary outcome measures pre- and post-treatment with LDX. Colored circles and error bars show the mean and standard error from the mean of individuals who experienced an increase (red), decrease (blue) or no change (green) in symptoms. The grey circle in the pre- column indicates the mean and SEM of trial non-completers. Black dashed lines indicate the cut off at which symptom levels may be considered above normative levels. Colour-coded text in the grey insets indicate the frequency and proportion of individuals reporting increases, decreases or no change in each measure. ASRS, Attention Deficit Hyperactivity Disorder Adult Self-Report Scale; HAM-A, Hamilton Anxiety scale; HAM-D, Hamilton Depression Rating Scale; EDEQ, Eating Disorders Examination Questionnaire; WHOQOL Psych, World Health Organisation Quality of Life Psychological Subscale
Fig. 3
Fig. 3
Plot showing significant interaction between change in log Binge Eating Frequency and anxiety (Hamilton Anxiety Rating Scale) from time 1 to 2. Following [32], we used the mean value of the moderator (i.e. change in verbal impulsivity) as well as one standard deviation above and below the mean value to plot the moderating effect of this measure on BE frequency between time points
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References

    1. Santomauro DF, Melen S, Mitchison D, Vos T, Whiteford H, Ferrari AJ. The hidden burden of eating disorders: an extension of estimates from the Global Burden of Disease Study 2019. Lancet Psychiatry. 2021;8(4):320–328. doi: 10.1016/S2215-0366(21)00040-7. - DOI - PMC - PubMed
    1. Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000–2018 period: a systematic literature review. Am J Clin Nutr. 2019;109(5):1402–1413. doi: 10.1093/ajcn/nqy342. - DOI - PubMed
    1. Udo T, Grilo CM. Psychiatric and medical correlates of DSM-5 eating disorders in a nationally representative sample of adults in the United States. Int J Eat Disord. 2019;52(1):42–50. doi: 10.1002/eat.23004. - DOI - PubMed
    1. Nazar BP, Bernardes C, Peachey G, Sergeant J, Mattos P, Treasure J. The risk of eating disorders comorbid with attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Int J Eat Disord. 2016;49(12):1045–1057. doi: 10.1002/eat.22643. - DOI - PubMed
    1. Hambleton A, Pepin G, Le A, Maloney D, Touyz S, Maguire S. Psychiatric and medical comorbidities of eating disorders: findings from a rapid review of the literature. J Eat Disord. 2022;10(1):132. doi: 10.1186/s40337-022-00654-2. - DOI - PMC - PubMed

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