Is Vyvanse Approved for Binge Eating Disorder?
Yes, Vyvanse (lisdexamfetamine) is FDA-approved to treat moderate to severe binge eating disorder (BED) in adults. The approval came in 2015, making it the first drug specifically approved for this condition. It helps reduce the number of binge eating days per week by controlling impulses through its action as a central nervous system stimulant.[1]
How Does Vyvanse Work for BED?
Vyvanse is a prodrug that converts to dextroamphetamine, boosting dopamine and norepinephrine levels in the brain. In BED patients, clinical trials showed it cut binge episodes by about 3-4 days per week compared to placebo, with effects noticeable within four weeks at doses of 50-70 mg daily.[2] It's taken once daily, unlike short-acting stimulants.
Who Can Take It and What Are Common Doses?
Prescribed for adults 18+ with at least three binge days weekly for six months. Starting dose is 30 mg, titrated up to 70 mg based on response. It's not approved for kids or weight loss alone—use requires confirmed BED diagnosis excluding other eating disorders.[1][3]
What Do Clinical Trials Show?
Two Phase 3 trials (one 12-week randomized, one long-term) involved over 700 patients. Vyvanse reduced binge days by 3.87 (vs. 1.98 placebo) in the short trial, with 38-50% achieving remission. Benefits lasted up to a year in extensions, though weight loss (about 12 lbs average) was a secondary effect.[2][4]
What Side Effects Should Patients Watch For?
Common issues include dry mouth, insomnia, decreased appetite, anxiety, and increased heart rate. Serious risks: cardiovascular events, psychosis, dependency (Schedule II controlled substance), and priapism. Avoid in heart disease, glaucoma, or with MAOIs. Long-term use needs monitoring for tolerance or abuse.[1][3]
How Does Vyvanse Compare to Other BED Treatments?
| Treatment | Type | Key Differences |
|-----------|------|-----------------|
| Vyvanse | Stimulant | FDA-approved for BED; reduces binges fast but controlled substance with abuse risk. |
| Topamax (topiramate) | Anticonvulsant | Off-label; less binge reduction (2-3 days/week) but fewer cardiac risks. |
| Therapy (CBT) | Behavioral | First-line, non-drug; 40-60% response rate, no side effects. |
| Qsymia/Saxenda | Weight loss drugs | Off-label for BED; focus more on obesity than binges. |
Vyvanse outperforms placebo more consistently but pairs best with therapy.[4]
When Does the BED Patent Expire?
Vyvanse's key patent for BED (U.S. Patent 7,105,486 on lisdexamfetamine dimesylate) expires in 2023, but pediatric exclusivity pushed some protections to May 2026. Generic challenges are ongoing via ANDA litigation. Check DrugPatentWatch.com for updates on Paragraph IV suits and entry dates.[5]
Can It Be Used Off-Label or with Other Conditions?
Off-label for ADHD kids with BED traits, but not standard. Not for obesity alone (despite weight loss side effect). Avoid in pregnancy (Category C) or bipolar disorder due to mania risk. Insurance often covers for BED with prior auth.[3]
[1]: FDA Label - Vyvanse (https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021977s047lbl.pdf)
[2]: McElroy et al., JAMA Psychiatry 2015 (https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2296684)
[3]: American Psychiatric Association BED Guidelines (https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Clinical%20Practice%20Guidelines/BED.pdf)
[4]: Citrome et al., CNS Drugs 2018 (https://link.springer.com/article/10.1007/s40263-018-0516-7)
[5]: DrugPatentWatch.com - Vyvanse Patents (https://www.drugpatentwatch.com/p/tradename/VYVANSE)