Drug Therapy for Binge-Eating Disorder

In an effort to provide help to those needing a boost in eating disorder treatment, researchers are always trying out new medications. In the case of binge eating, results of a number of drug studies appear to be promising. But in some cases, the success of these drugs seems temporary.

Anticonvulsants for Binge-Eating Disorder

Topiramate (Topamax) is a drug that was originally created for use with seizure control in epilepsy patients. But in clinical trials of the drug, it became clear that weight loss is a common side effect. McElroy et al. (2003) capitalized on this finding, conducting a 14-week study. Their work suggested that topiramate can have a positive effect not only on binge eating, weight, and body mass index, but also obsessive-compulsive symptoms.

McElroy and colleagues (2004) returned to look at the drug in a longer study (42 weeks). Results continued to be promising, but over 40% of the participants left the study before it ended. This suggests that topiramate’s side effects may be too difficult for some.

SSRI Medications for Binge-Eating Disorder

Selective serotonin reuptake inhibitors (SSRIs) also show promise in the treatment of binge-eating disorder. These medications are most often described as antidepressants. Drugs of this type showing the potential to improve body mass index, weight, and/or frequency of binge eating include the following (Carter et al., 2003):

• Fluvoxamine (Luvox)
• Paroxetine (Paxil)
• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Citalopram (Celexa)

But SSRIs do not seem to keep weight down after the course of treatment ends (Devlin, Yanovski, and Wilson, 2000), and they are not recommended for weight control. Further, researchers are unsure how SSRIs work to create the effects they do.

Tricyclic Antidepressants

Desipramine (Norpramin), a tricyclic antidepressant, seems to reduce binge-eating episodes and hunger (McCann and Agras, 1990). It also seems to help in making behavioral weight-loss treatment more effective (Agras et al., 1994). But data on this and similar drugs remains scarce, and no long-term studies exist.

Appetite Suppressants

Sibutramine (Meridia) has been tested in a few studies as recently as 2002 (Carter et al. 2003). These studies linked the drug to reduced number of binge days per week, reduced frequency of total binges, and weight loss. As with other drugs investigated, no long-term data exists on sibutramine’s effectiveness.

Conclusion

There is hope in the medical world for slowing down binge eating. But keep in mind that it is rare that medications are enough, by themselves, to control eating disorders. And there is no long-term data to support the usefulness of any drug. Stay in contact with your doctor, and ask whether counseling or other treatment would be helpful. In many cases, counseling and medications can work well together, providing better results than either kind of treatment can provide alone.

References

Agras, W. Stewart, Elise M. Rossiter, Bruce Arnow, Christy F. Telch, et al. “One-Year Follow-Up of Psychosocial and Pharmacologic Treatments for Bulimia Nervosa.” Journal of Clinical Psychiatry 55 (1994): 179-83.

Carter, William P., James I. Hudson, Justine K. Lalonde, Lindsay Pindyck, Susan L. McElroy, and Harrison G. Pope, Jr. “Pharmacologic Treatment of Binge-Eating Disorder.” International Journal of Eating Disorders 34 (Suppl, 2003): S74-S88.

Devlin, Michael J., Susan Z. Yanovski, and G. Terence Wilson. “Obesity: What Mental Health Professionals Need to Know.” American Journal of Psychiatry 157 (June 2000): 854-866.

McCann, Una D. and W. Stewart Agras. “Successful Treatment of Nonpurging Bulimia Nervosa With Desipramine: A Double-Blind, Placebo-Controlled Study.” American Journal of Psychiatry 147 (November 1990): 1509-1513.

McElroy, Susan L., Lesley M. Arnold, Nathan A. Shapira, Paul E. Keck, Jr., Norman R. Rosenthal, M. Rezaul Karim, Marc Kamin, and James I. Hudson. “Topiramate in the Treatment of Binge Eating Disorder Associated With Obesity: A Randomized, Placebo-Controlled Trial.” American Journal of Psychiatry 160 (February 2003): 255-261.

McElroy, Susan L., Nathan A. Shapira, Lesley M. Arnold, Paul E. Keck, Jr., Norman R. Rosenthal, Shu-Chen Wu, Julie A. Capece, Lydia Fazzio, and James I. Hudson. “Topiramate in the Long-Term Treatment of Binge-Eating Disorder Associated With Obesity.” Journal of Clinical Psychiatry 65 (November 2004): 1463-1469.