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Vyvanse: The pill you shouldn't use to lose weight

This popular ADHD drug is now approved to treat binge eating, but it's not a safe tool for weight loss

Published: March 11, 2015 02:30 PM

The Food and Drug Administration (FDA) recently approved Vyvanse (lisdexamfetamine dimesylate), a drug widely used for attention deficit hyperactivity disorder, to help curtail something else entirely—binge eating in adults. That might give you the impression that taking Vyvanse is a good way to drop some pounds. But the FDA makes clear—and our experts agree—that this stimulant medication should not be used as a diet drug.

For starters, “binge eating disorder” is not the same thing as eating too much. People diagnosed with this disorder experience episodes—often several times a week—where they report feeling out of control and compulsively overeat until they are uncomfortably full. Many report feeling embarrassed afterward and may avoid other people due to shame over how much they’ve eaten in a relatively short period of time.

Binge eating has been recognized as a serious problem for some time, but was only officially classified in 2013 as a disorder like anorexia or bulimia nervosa. Because there wasn’t another FDA-approved drug treatment for binge-eating, the agency agreed to fast-track Vyvanse through the approval process. And, although the agency often asks an independent panel of experts to review evidence on older products put to new use, they opted to skip that step in this case, noting that Vyvane’s safety record as an ADHD drug was sufficiently reassuring.

Find out why you should skip weight loss drugs, too, and what's wrong with herbal remedies.

Ultimately, the agency approved the drug based on two 12-week clinical trials involving a total of 724 people with the disorder. Those studies showed that on average, people were binging less by the end of the study—regardless of whether they took the drug or a placebo (sugar pill). However, people who took a 50- or 70-milligram dose of Vyvanse reduced the number of binge episodes more than those who took a 30-mg dose or a placebo. It’s not clear if the desire to binge eat resumes when people stop taking the drug, or if taking the drug for a longer period of time results in a higher risk of side effects. Test results from follow-up studies the FDA required won’t be available for at least three years.

No good drugs, including Vyvanse, for weight loss

 
While the evidence that Vyvanse is safe or effective at helping curb binge eating is small, there is zero research on using it for losing weight. In fact, the FDA specifically recommends against using the drug, which is a central nervous system stimulant, for weight loss. They're not alone: Many experts take it a step farther and don't recommend even using stimulants that have been FDA approved for weight loss. Those include drugs like:
  • benzphetamine (Didrex, Regimex, and generic)
  • diethylpropion (Tenuate and generic)
  • phendimetrazine (Adipost, Bontril, Melfiat, and generic),
  • phentermine (Adipex-P, Ionamin, Fastin, and generic).
While stimulants were once popular diet aids, over time it became apparent that that type of drug harmed dieters more than they helped. The drugs proved addicting and increased the dieters’ risk for heart attack and stroke. Several stimulant drugs, including the prescription drug sibutramine (Meridia), over-the-counter diet aids containing phenylpropanolamine (PPA) and ephedrine, as well as supplements containing ma huang (an ephedrine-like compound) and 1,3-dimethylamylamine (DMAA) were removed from the market because of safety concerns.
 
 “We had a terrible experience in the U.S. with amphetamines prescribed for appetite suppression,” says Andrew Kolodny, M.D., chief medical officer at Phoenix House, a multi-state network of addiction treatment centers. “Thousands became addicted or suffered other serious side effects including amphetamine-induced psychosis and heart attacks.”  
 
Vyvanse carries many of those same risks. The drug is classified as a Schedule II controlled substance because it has a high potential for abuse and people can become physically dependent on it. Like other stimulants, it can raise blood pressure and heart rate and increases the risk of heart attack or stroke and even sudden death in people who have heart problems or heart defects. The drug can also trigger psychiatric problems, including hallucinations, delusions, or mania, even in people with no history of psychotic illness.
 
—Teresa Carr

Editor's Note:

These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by a multistate settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).



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