Abstract
Lisdexamfetamine dimesylate (LDX) is the only drug currently approved by the FDA for the treatment of Binge-Eating Disorder (BED), but little is known about the behavioural mechanisms that underpin the efficacy of LDX in treating BED. We examined the behavioural and neural effects of an acute dose of LDX (50 mg) in 22 women with binge-eating symptomatology using a randomised, crossover, double-blind, placebo-controlled experimental medicine design. LDX reduced self-reported appetite ratings and intake of both a pasta meal and a palatable cookie snack. LDX also decreased the eating rate of pasta but not of cookies and reduced self-reported liking ratings for pasta at the end of the meal. When viewing food pictures during an fMRI scan, LDX reduced activity bilaterally in the thalamus. LDX enhanced sustained attention and reduced impulsive responding in a continuous performance task but had no effect on emotional bias or working memory. These results suggest the observed effects of LDX on food intake (and by implication the efficacy of LDX in treating BED) may be related to the actions of the drug to enhance satiety, reduce food-related reward responding when full and/or increase cognitive control. Novel pharmacotherapies for BED might be most effective if they have a broad spectrum of effects on appetite, reward and cognition.
Highlights
Binge-eating disorder (BED) is the most common specific eating disorder, and the estimated lifetime global prevalence is between 0.9–2.2.% [1]
Emotional recognition memory (EMEM): Participants were presented with the 60 words from the Emotional categorisation (ECAT), along with 60 matching novel distractor we predicted that lisdexamfetamine dimesylate (LDX) might reduce neural responses to the viewing of food pictures in areas of the brain involved in reward and homeostatic processes
Using the factor structure calculated by Thomas et al [15], visual analogue scales (VAS) factors consisted of ‘Arousal’, ‘Appetite’ (hunger, fullness, and RESULTS Participant characteristics The women were on average overweight (mean BMI = 26.35 (4.98)), and the majority (59%) scored Severe on the Binge-Eating Scale (BES) (mean score 28.36 (6.59))
Summary
Binge-eating disorder (BED) is the most common specific eating disorder, and the estimated lifetime global prevalence is between 0.9–2.2.% [1]. Emotional recognition memory (EMEM): Participants were presented with the 60 words from the ECAT, along with 60 matching novel distractor we predicted that LDX might reduce neural responses to the viewing of food pictures in areas of the brain involved in reward and homeostatic processes.
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