Lisdexamfetamine (Vyvanse)

Lisdexamfetamine is a medication that serves dual purposes in treatment. While primarily known for treating ADHD, it has an important application in managing binge eating disorder in adults. Here's what you need to know about this versatile medication.

What's It For?

Lisdexamfetamine has two primary approved uses:

• Treatment of Attention Deficit Hyperactivity Disorder (ADHD) in adults and children 6 years and older
• Management of moderate to severe binge eating disorder (BED) in adults

When prescribed for binge eating disorder, the medication can help reduce the frequency of binge eating episodes and associated behaviors. It's important to note that it is not approved for weight loss, though some patients may experience weight changes as a side effect.

How It Works

Lisdexamfetamine works differently from many other medications because it's what's known as a "prodrug." This means:

• The medication itself is inactive when you take it
• Your body metabolizes (processes) it, converting it into dextroamphetamine, which is the active compound
• Once activated, it increases levels of certain neurotransmitters (dopamine and norepinephrine) in the brain

For people with binge eating disorder, these changes in brain chemistry can help improve impulse control and reduce the urge to binge eat. The gradual conversion process in the body also helps create a smoother, more consistent effect throughout the day.

How to Take It

Proper administration of lisdexamfetamine is essential for both safety and effectiveness:

• Take exactly as prescribed, typically once daily in the morning
• Can be taken with or without food
• Capsules can be swallowed whole or opened and the contents dissolved in water
• Avoid taking late in the day as it may interfere with sleep

Your doctor will determine the appropriate dosage based on your specific condition, response to treatment, and other factors. Never adjust your dosage without consulting your healthcare provider first.

Side Effects: The Real Deal

As a stimulant medication, lisdexamfetamine has a distinct side effect profile that differs from other weight management medications.

Common Side Effects

Many people experience some of these effects, particularly when first starting treatment:

• Decreased appetite (which may lead to weight loss)
• Dry mouth
• Difficulty sleeping (insomnia)
• Irritability or mood changes
• Increased heart rate or blood pressure
• Headache
• Stomach upset or constipation

These side effects are often temporary and may improve as your body adjusts to the medication. Strategies like drinking plenty of water, maintaining good sleep hygiene, and taking the medication early in the day can help manage some of these effects.

Serious Side Effects

Though less common, more serious side effects require immediate medical attention:

• Chest pain or shortness of breath
• Severe mood swings, hallucinations, or suicidal thoughts
• Circulation problems (numbness, coldness, or color changes in fingers or toes)
• Seizures
• Blurred vision or other visual disturbances

Contact your healthcare provider immediately if you experience any of these serious side effects.

Making It Work For You

To maximize benefits and minimize risks with lisdexamfetamine, consider these important guidelines:

Dependency Risk

Lisdexamfetamine is classified as a Schedule II controlled substance due to its potential for dependence. Take only as prescribed, never increase your dose without medical supervision, and never share your medication with others.

Medical History

Be forthcoming with your doctor about your complete medical history, especially if you have:

• Heart problems or high blood pressure
• Mental health conditions
• History of substance abuse or addiction
• Seizure disorder
• Thyroid issues
• Glaucoma

Lifestyle Considerations

While taking lisdexamfetamine:

• Avoid alcohol, as it may increase the risk of side effects
• Stay well-hydrated to help manage dry mouth
• Maintain a regular sleep schedule and practice good sleep hygiene
• Monitor your mood and report any concerning changes to your doctor

Medication Interactions

Lisdexamfetamine can interact with several medications, including:

• MAO inhibitors (certain antidepressants)
• Blood pressure medications
• Seizure medications
• Antacids
• Other stimulants

Always provide your healthcare provider with a complete list of all medications, supplements, and herbs you're taking.

Bottom Line

Lisdexamfetamine offers a treatment option for adults struggling with binge eating disorder who haven't responded adequately to psychological interventions alone. Unlike some other medications used for weight-related issues, it specifically targets the behaviors and impulse control issues associated with binge eating.

Because it's a controlled substance with potential for dependency, the decision to use lisdexamfetamine should be carefully considered in partnership with your healthcare provider, weighing both benefits and risks based on your individual situation.