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Secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa

BACKGROUND: There is emerging evidence that stimulants warrant further investigation as a treatment for bulimia nervosa (BN) including a recent open-label feasibility trial examining the use of lisdexamfetamine dimestylate (LDX) for BN. The current report presents the secondary outcomes and qualitat...

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Autores principales: Dixon, Laura, Bartel, Sara, Brown, Victoria, Ali, Sarrah I., Gamberg, Susan, Murphy, Andrea, Brewer, Katherine L., McElroy, Susan L., Kaplan, Allan, Nunes, Abraham, Keshen, Aaron R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204259/
https://www.ncbi.nlm.nih.gov/pubmed/37218020
http://dx.doi.org/10.1186/s40337-023-00796-x
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author Dixon, Laura
Bartel, Sara
Brown, Victoria
Ali, Sarrah I.
Gamberg, Susan
Murphy, Andrea
Brewer, Katherine L.
McElroy, Susan L.
Kaplan, Allan
Nunes, Abraham
Keshen, Aaron R.
author_facet Dixon, Laura
Bartel, Sara
Brown, Victoria
Ali, Sarrah I.
Gamberg, Susan
Murphy, Andrea
Brewer, Katherine L.
McElroy, Susan L.
Kaplan, Allan
Nunes, Abraham
Keshen, Aaron R.
author_sort Dixon, Laura
collection PubMed
description BACKGROUND: There is emerging evidence that stimulants warrant further investigation as a treatment for bulimia nervosa (BN) including a recent open-label feasibility trial examining the use of lisdexamfetamine dimestylate (LDX) for BN. The current report presents the secondary outcomes and qualitative interview results from that feasibility trial. These outcomes explore several purported mechanisms that may explain how stimulants affect symptoms of BN: appetite, impulsivity, obsessive and compulsive symptoms, eating disorder psychopathology/impairment and reward-based decision-making. METHODS: Twenty-three participants with BN received LDX for eight weeks. Questionnaires assessing appetite, impulsivity, obsessive and compulsive symptoms, eating disorder psychopathology and impairment were administered at baseline and post-treatment. Participants also completed a two-step reinforcement learning task to assess their decision-making. Semi-structured interviews took place at baseline, week 5, and follow-up. RESULTS: Reductions in hunger, food-related impulsivity, obsessive and compulsive features, eating disorder psychopathology and impairment were found. However, reward learning, as far as it is assessed by the task, did not seem to contribute to the effect of LDX on BN symptoms. Qualitative analysis suggested four themes: (1) reprieve from the eating disorder, (2) improvement in function and quality of life, (3) renewed hope for recovery, and (4) ability to normalize eating. CONCLUSIONS: This report suggests several potential mechanisms by which LDX may reduce symptoms of binging and purging in those with BN. Importantly, due to the open-label design, we are unable to attribute findings to the medication. Instead, our results should be interpreted as hypothesis generating to inform future studies such as adequately powered randomized controlled trials. Trial registration NCT03397446. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40337-023-00796-x.
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spelling pubmed-102042592023-05-24 Secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa Dixon, Laura Bartel, Sara Brown, Victoria Ali, Sarrah I. Gamberg, Susan Murphy, Andrea Brewer, Katherine L. McElroy, Susan L. Kaplan, Allan Nunes, Abraham Keshen, Aaron R. J Eat Disord Research BACKGROUND: There is emerging evidence that stimulants warrant further investigation as a treatment for bulimia nervosa (BN) including a recent open-label feasibility trial examining the use of lisdexamfetamine dimestylate (LDX) for BN. The current report presents the secondary outcomes and qualitative interview results from that feasibility trial. These outcomes explore several purported mechanisms that may explain how stimulants affect symptoms of BN: appetite, impulsivity, obsessive and compulsive symptoms, eating disorder psychopathology/impairment and reward-based decision-making. METHODS: Twenty-three participants with BN received LDX for eight weeks. Questionnaires assessing appetite, impulsivity, obsessive and compulsive symptoms, eating disorder psychopathology and impairment were administered at baseline and post-treatment. Participants also completed a two-step reinforcement learning task to assess their decision-making. Semi-structured interviews took place at baseline, week 5, and follow-up. RESULTS: Reductions in hunger, food-related impulsivity, obsessive and compulsive features, eating disorder psychopathology and impairment were found. However, reward learning, as far as it is assessed by the task, did not seem to contribute to the effect of LDX on BN symptoms. Qualitative analysis suggested four themes: (1) reprieve from the eating disorder, (2) improvement in function and quality of life, (3) renewed hope for recovery, and (4) ability to normalize eating. CONCLUSIONS: This report suggests several potential mechanisms by which LDX may reduce symptoms of binging and purging in those with BN. Importantly, due to the open-label design, we are unable to attribute findings to the medication. Instead, our results should be interpreted as hypothesis generating to inform future studies such as adequately powered randomized controlled trials. Trial registration NCT03397446. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40337-023-00796-x. BioMed Central 2023-05-22 /pmc/articles/PMC10204259/ /pubmed/37218020 http://dx.doi.org/10.1186/s40337-023-00796-x Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Dixon, Laura
Bartel, Sara
Brown, Victoria
Ali, Sarrah I.
Gamberg, Susan
Murphy, Andrea
Brewer, Katherine L.
McElroy, Susan L.
Kaplan, Allan
Nunes, Abraham
Keshen, Aaron R.
Secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa
title Secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa
title_full Secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa
title_fullStr Secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa
title_full_unstemmed Secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa
title_short Secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa
title_sort secondary outcomes and qualitative findings of an open-label feasibility trial of lisdexamfetamine dimesylate for adults with bulimia nervosa
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204259/
https://www.ncbi.nlm.nih.gov/pubmed/37218020
http://dx.doi.org/10.1186/s40337-023-00796-x
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