Normalizing the Neural Correlates of Binge-Eating Disorder with Lisdexamfetamine: A Case Report and Literature Review

Abstract

The brain regions associated with binge-eating disorder (BED) and those targeted by Lisdexamfetamine (LDX) overlap. The present paper reviews the psychobehavioural and neuropharmacological mechanisms at play in BED and compulsive eating behaviours, along with the mechanisms of action LDX is thought to play. We present one case of chronic BED and highlight the EEG scans pre-and post-LDX treatment. The normalization of the patient's electroencephalogy (EEG) activity associated with BED after LDX supports theorized mechanisms of LDX action, further explaining its efficacy in treatment. A significant decrease in theta band power was observed in the patient after treatment with LDX. Specifically, this decrease was modulated by changes in the F8 electrode corresponding to the orbitofrontal cortex (OFC)-An area associated with deficits in inhibitory function, seen in addictions and BED. A better understanding of the psychobehavioural and neuropharmacological mechanisms involved in BED and LDX treatment has the potential to significantly enhance our knowledge of the underlying pathogenesis, potential prevention, and optimal treatment options for patients.

Lisdexamfetamine and binge-eating disorder: A systematic review and meta-analysis of the preclinical and clinical data with a focus on mechanism of drug action in treating the disorder

“…These studies reported percentage improvements in self-reported symptoms in most of the participants, but a worsening of symptoms after LDX treatment in 2 of 25 cases (Guerdjikova et al, 2019). The results of Brucar et al (2018) did not include a symptom improvement outcome. Fleck et al (2019) reported that LDX improved BED symptoms using the CGI, YBOCS-BE, and BES.…”

“…Of the 14 clinical articles, four (Guerdjikova et al, 2016;Hudson et al, 2017;McElroy et al, 2015a;McElroy et al, 2015c) reported the results of a randomised controlled trial (RCT), and one reported the results of two RCTs (McElroy et al, 2016a). Three articles reported the results of open-label studies (Fleck et al, 2019;Gasior et al, 2017;Hudson et al, 2017), two were case reports (Brucar et al, 2018;Srivastava et al, 2019), two were retrospective medical record reviews (Guerdjikova et al, 2019;Keshen & Helson, 2017) and three were secondary data analyses (Kornstein et al, 2019;McElroy et al, 2017;McElroy et al, 2016b).…”

“…Ages ranged from 12-56 years. Three studies (Gasior et al, 2017;Guerdjikova et al, 2019;Hudson et al, 2017) recruited men and women (although the majority of participants were women), three studies (Brucar et al, 2018;Fleck et al, 2019;Srivastava et al, 2019) included only women, and one study did not report sex/gender (Keshan et al, 2017). Adult BMI ranged from 33.75-48.89 kg/m 2 and mean paediatric BMI percentile was 97.5 (Guerdjikova et al, 2019).…”

“…Adult BMI ranged from 33.75-48.89 kg/m 2 and mean paediatric BMI percentile was 97.5 (Guerdjikova et al, 2019). Two studies did not report BMI (Brucar et al, 2018;Keshan et al, 2017). Of the studies that reported co-morbidities (n=2), the disorders reported included: depressive disorders, generalised anxiety disorder, ADHD, developmental delay/autism, milieu instability, marijuana use disorder, dependent traits, avoidant personality traits, dependent personality traits, obsessive-compulsive personality traits, and social anxiety disorder.…”

“…(2019) did not measure binge eating frequency, while Brucar et al (2018) reported that LDX reduced binge-eating episodes and induced cessation of binge eating. An analysis of 25 records showed LDX reduced binge eating frequency in 6 cases (Guerdjikova et al, 2019).…”