Patient perceptions of lisdexamfetamine as a treatment for binge eating disorder: An exploratory qualitative and quantitative analysis

Lisdexamfetamine (LDX) is the only medication to have gained FDA approval for the treatment of binge eating disorder (BED). LDX treatment is generally effective at reducing binge eating symptoms but is associated with several unwanted side effects. How BED patients perceive the therapeutic efficacy vs. associated side effects of LDX has not been explored. We carried out a thematic analysis of 111 online reviews posted to the website Drugs.com by persons prescribed LDX to treat BED. We also explored how qualitative themes were associated with perceptions of treatment efficacy on a quantitative (1–10 scale) scale. Themes associated with higher efficacy ratings included improved binge eating outcomes, enhanced focus/concentration, as well as weight loss (χ² tests, p's < 0.05). Lower efficacy ratings were associated with themes that included tolerance to therapeutic effects of LDX, insomnia, return of binge eating in the evening, loss of energy in the afternoon/evening (‘crashing’), and weight gain (χ² tests, p's < 0.05). Limitations of the study include representativeness of the data and self-reported BED diagnosis. Together, these data provide novel insights into individual experiences with LDX as a treatment for BED and their association with perceived efficacy. The causal nature of these relationships should be tested in future studies, as well as any implications for medication adherence.