***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: The relative bioavailability of oral lisdexamfetamine dimesylate , a prodrug of d-amphetamine , and active d-amphetamine was assessed in an open-label , single-dose , 3-treatment , 3-period , r and omized , crossover study in 18 healthy adult volunteers . Following a fast of at least 10 hours , subjects were administered an intact capsule of 70 mg lisdexamfetamine , a solution containing the capsule contents , or an intact capsule with a high-fat meal . St and ard meals started 4 hours following lisdexamfetamine administration . Blood sample s were taken predose ( 0 hours ) and 0.5 to 72 hours postdose , and the concentrations of d-amphetamine and lisdexamfetamine  were measured . AUC and C(max ) for d-amphetamine were similar when lisdexamfetamine 70 mg was administered to healthy adults in the fed or fasted state . The AUC of intact lisdexamfetamine  was similar when the latter was taken without food or in solution , but C(max ) was lower when lisdexamfetamine was administered with food . The t(max ) of d-amphetamine and intact lisdexamfetamine  was similar when taken in solution or in the fasted state but was about 1 hour longer when taken with food . Adverse events were typical for amphetamine products . These findings indicate that food does not have a significant effect on  d-amphetamine or lisdexamfetamine bioavailability in healthy adults and that lisdexamfetamine was well tolerated Abstract Lisdexamfetamine dimesylate ( LDX ) is the first prodrug stimulant and is indicated for the treatment of attention-deficit/hyperactivity disorder . A single-centre , double-blind , r and omised , placebo-controlled , 6-period crossover study evaluated the abuse potential of single oral doses of 50 , 100 ( equivalent to 40 mg d-amphetamine ) , and 150 mg LDX , 40 mg d-amphetamine and 200 mg diethylpropion in 36 individuals with a history of stimulant abuse . On the primary abuse liability measure , maximum change of the Drug Rating Question naire-Subject Liking Scale compared with placebo , d-amphetamine and diethylpropion showed significant differences of 4.5 and 4.0 units , respectively ( P < 0.001 for both vs placebo ) . LDX , administered at 50 , 100 and 150 mg , showed nonsignificant differences of 2.0 and 2.1 units , respectively , at the two lower doses but a significant ( P < 0.001 vs placebo ) difference of 6.1 units at the highest dose . Subjects significantly favoured d-amphetamine 40 mg versus LDX 100 mg ( 2.4 units difference ; P < 0.05 ) . There was no significant difference in liking scores between d-amphetamine 40 mg and LDX 150 mg . Drug Rating Question naire-Subject Feel-Drug-Effect score was significantly lower for 100 mg LDX than for 40 mg d-amphetamine . There were no statistically significant differences between LDX and diethylpropion hydrochloride , a Schedule IV amphetamine-like stimulant , on abuse-related liking scores . Cardiovascular responses of LDX and d-amphetamine were similar at equivalent doses . In conclusion , at an equivalent amount of amphetamine base taken orally , LDX 100 mg had attenuated responses on measures of abuse liability compared with immediate-release d-amphetamine 40 mg . Abuse-related liking scores of LDX at a dose corresponding to a 50 % higher amphetamine base ( LDX 150 mg ) were similar to d-amphetamine 40 mg ABSTRACT Objective : To evaluate the pharmacokinetics of lisdexamfetamine dimesylate ( LDX ; Vyvanse * ) in fasting healthy adult volunteers . Background : LDX is the first pro-drug stimulant and is indicated for the treatment of attention-deficit/hyperactivity disorder . LDX was developed with the goal of providing an extended effect that is consistent throughout the day , with a reduced potential for abuse , overdose toxicity , and drug tampering . Methods : This was an open-label , multiple-dose phase 1 study . LDX 70 mg/d was administered in the morning to 12 subjects for 7 days . Twenty blood sample s were drawn during the study . Descriptive statistics were used for pharmacokinetic parameters . Results : Based on Cmin , steady-state d-amphetamine concentration ( 20.6 ng/mL ) was reached by day 5 , whereas LDX was undetectable , and 95 % of the d-amphetamine was eliminated within 48 hours following the final dose on day 7 . At steady state , d-amphetamine achieved a mean ± st and ard deviation Cmax of 90.1 ± 29.6 ng/mL , with a median Tmax of 3.0 hours . The AUC0–inf for d-amphetamine was 1453 ± 645.7 ng.h/mL.Complete elimination of the pro-drug occurred approximately 6 hours following the final dose on day 7 . Adverse events were mild to moderate and similar to other oral amphetamines . Conclusions : This study describes the steady-state pharmacokinetics of LDX , a new pro-drug stimulant . Possible study limitations include an open-label design and a small sample size The pharmacokinetics of lisdexamfetamine dimesylate , a long-acting prodrug stimulant , and its active moiety , d-amphetamine , including dose-proportionality and variability , were assessed in 20 healthy adults . Subjects received a single dose , sequentially , of 50 , 100 , 150 , 200 , and 250 mg of lisdexamfetamine dimesylate . Plasma lisdexamfetamine dimesylate and d-amphetamine were measured before dosing and 0.25 to 96 hours postdose . Dose-proportionality and intersubject and intrasubject variability of pharmacokinetic parameters were examined . Safety assessment s included adverse events . All 20 subjects received 50 and 100 mg while 18 , 12 , and 9 subjects received 150 , 200 , and 250 mg of lisdexamfetamine dimesylate , respectively . Ten subjects were discontinued during the study for prespecified stopping rules ( 2 consecutive hourly readings of blood pressure : systolic > 160 mm Hg or diastolic > 100 mm Hg ) . Mean maximum observed plasma concentration ( C(max ) ) and area under the concentration-time curve from time 0 to infinity ( AUC(0-∞ ) ) increased linearly and dose-dependently for d-amphetamine . Median time to C(max ) ranged from 4 to 6 hours for d-amphetamine and 1.0 to 1.5 hours for lisdexamfetamine dimesylate .  Intersubject and intrasubject variability over doses from 50 to 150 mg was low ( < 20 % ) for both C(max ) and AUC(0-∞ ) . Adverse events included nausea , dizziness , headache , psychomotor hyperactivity , and dysuria . These findings indicate that the pharmacokinetic parameters of d-amphetamine were dose-proportional and predictable over a wide range of lisdexamfetamine dimesylate doses IMPORTANCE  Binge-eating disorder ( BED ) , a public health problem associated with psychopathological symptoms and obesity and possibly with metabolic syndrome , lacks approved pharmacotherapies . OBJECTIVE To examine the efficacy and safety of lisdexamfetamine dimesylate , a dextroamphetamine prodrug , to treat moderate to severe BED . DESIGN , SETTING , AND PARTICIPANTS We performed a r and omized , double-blind , parallel-group , forced dose titration , placebo-controlled clinical trial at 30 sites from May 10 , 2011 , through January 30 , 2012 . Safety and intention-to-treat analyses included 259 and 255 adults with BED , respectively . INTERVENTIONS Lisdexamfetamine dimesylate at dosages of 30 , 50 , or 70 mg/d or placebo were provided to study participants ( 1:1:1:1 ) . Dosages were titrated across 3 weeks and maintained for 8 weeks . We followed up participants for a mean ( SD ) of 7 ( 2 ) days after the last dose . MAIN OUTCOMES AND MEASURES We assessed the change in binge-eating ( BE ) behaviors measured as days per week ( baseline to week 11 ) with a mixed-effects model using transformed log ( BE days per week ) + 1 . Secondary measures included BE cessation for 4 weeks . Safety assessment s included treatment-emergent adverse events , vital signs , and change in weight . RESULTS At week 11 , log-transformed BE days per week decreased with the 50-mg/d ( least squares [ LS ] mean [ SE ] change , -1.49 [ 0.066 ] ; P = .008 ) and 70-mg/d ( LS mean [ SE ] change , -1.57 [ 0.067 ] ; P < .001 ) treatment groups but not the 30-mg/d treatment group ( LS mean [ SE ] change , -1.24 [ 0.067 ] ; P = .88 ) compared with the placebo group . Nontransformed mean ( SD ) days per week decreased for placebo and the 30- , 50- , and 70-mg/d treatment groups by -3.3 ( 2.04 ) , -3.5 ( 1.95 ) , -4.1 ( 1.52 ) , and -4.1 ( 1.57 ) , respectively . The percentage of participants achieving 4-week BE cessation was lower with the placebo group ( 21.3 % ) compared with the 50-mg/d ( 42.2 % [ P = .01 ] ) and 70-mg/d ( 50.0 % [ P < .001 ] ) treatment groups . The incidence of any treatment-emergent adverse events was 58.7 % for the placebo group and 84.7 % for the combined treatment group . In the treatment groups , 1.5 % of participants had serious treatment-emergent adverse effects . Events with a frequency of at least 5 % and changes in heart rate were generally consistent with the known safety profile . The mean ( SD ) change in body weight was -0.1 ( 3.09 ) , -3.1 ( 3.64 ) , -4.9 ( 4.43 ) , -4.9 ( 3.93 ) , and -4.3 ( 4.09 ) kg for the placebo group , the 30- , 50- , and 70-mg/d treatment groups , and the combined treatment groups , respectively ( P < .001 for each dose vs placebo group comparison in post hoc analysis ) . CONCLUSIONS AND RELEVANCE The 50- and 70-mg/d treatment groups demonstrated efficacy compared with the placebo group in decreased BE days , BE cessation , and global improvement . The safety profile was generally consistent with previous findings in adults with attention-deficit/hyperactivity disorder . Further investigation of lisdexamfetamine in BED is ongoing . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01291173 The two specialty psychological therapies of CBT and IPT remain the treatments of choice for the full range of BED patients , particularly those with high levels of specific eating disorder psychopathology such as overvaluation of body shape and weight . They produce the greatest degree of remission from binge eating as well as improvement in specific eating disorder psychopathology and associated general psychopathology such as depression . The CBT protocol evaluated in the research summarized above was the original manual from Fairburn and colleagues . Fairburn has subsequently developed a more elaborate and sophisticated form of treatment , namely , enhanced CBT ( CBT-E ) for eating disorders . Initial research suggests that CBT-E may be more effective than the earlier version with bulimia nervosa and Eating Disorder Not Otherwise Specified patients .  CBT-E has yet to be evaluated for the treatment of BED , although it would currently be the recommended form of CBT . Of relevance in this regard is that the so-called broad form of the new protocol includes 3 optional treatment modules that could be used to address more complex psychopathology in BED patients . One of the modules targeted at interpersonal difficulties is IPT , as described earlier in this chapter . Thus , the broader protocol could represent a combination of the two currently most effective therapies for BED . Whether this combined treatment proves more effective than either of the components alone , particularly for a subset of BED patients with more complex psychopathology , remains to be tested . CBT-E also includes a module design ed to address what Fairburn terms “ mood intolerance ” ( problems in coping with negative affect ) that can trigger binge eating and 
    Output:
    
LDX is the first pharmacological agent that has received regulatory approval for the treatment of BED .
LDX 50 or 70 mg/day significantly reduced BED symptoms as measured by the number of binge eating days per week .