Lisdexamfetamine dimesylate reduces food intake and improves cognitive control in women with binge-eating symptoms

Lisdexamfetamine dimesylate (LDX) is the only drug approved by the FDA for treatment of Binge Eating Disorder (BED). Little, however, is known about the behavioural mechanisms that underpin the efficacy of LDX in treating BED. The current study used a randomised, crossover, double-blind, placebo-controlled design to investigate the effects of LDX in women with binge-eating symptoms (BES). Twenty-two women (BMI = 26.35 kg/m2 ± 4.98; age = 24.41 ± 6.87) with BES (Binge Eating Scale M = 28.36 ± 6.59) received either 50mg LDX or placebo in a counterbalanced order. Participants completed cognitive tests, mood and appetite questionnaires, and had ad libitum access to a pasta meal and a cookie snack. LDX reduced both pasta and cookie intake (F(1, 21) = 11.65, p < 0.01), with a greater effect on cookie intake (d = 0.65) than pasta intake (d = 0.52). LDX also decreased eating rate (grams/minute) for pasta (t(21) = -3.14, p = 0.01), but not for cookies (p > 0.05). LDX reduced self-reported liking ratings for pasta at the end of the meal (t(21) = -2.57, p = 0.02) and self-reported appetite ratings (F(1, 21) = 27.56, p < 0.01). On a measure of sustained attention, LDX reduced commission errors (F(1, 21) = 4.47, p = 0.048). These results suggest the observed effects of LDX on food intake (and by implication the efficacy of LDX in treating BED) could be related to the actions of the drug to reduce appetite and/or increase cognitive control.