What Drugs Are Used To Treat Binge Eating Disorder?

BED is a very severe and complex clinical issue because of its association with high psychiatric comorbidity and suicidal risk. Individuals with binge eating disorder (BED) and ADHD have high rates of comorbidity.[1, 2] Antidepressant treatment is often recommended as binge eating disorder treatment because of its association with neurobiological factors, depressive and obsessional psychopathology and high rates of comorbidity factors. [3] [4]

The objectives of Drug Treatment of Binge Eating Disorder

·        To prevent the possibility of the individual returning to binge eating after recovery [5]

·        To treat comorbid psychopathology like overweight and restore patients to healthy weights.

·        To address significant behavioral conflict in BED like distress, low self-worth, and impulsive eating.

·        To improve patient’s acceptability, total wellbeing and solicit support of the family members of binge episode victims

·        To address dysfunctional behavioral regulation

·        To enhance associated psychological difficulties and treat physical complications

 

Treatment for binge eating disorder

The key role of binge eating disorder treatment is to minimize binge eating habits and possibly help the individual to lose weight. Given that binge eating is associated with a feeling of remorse, embarrassment and low self-esteem, binge treatment is as well targeted at eradicating the psychological effects of binge eating.

Recent studies suggest that the best-recommended treatment for binge eating disorder is through psychotherapeutic methods.  [6, 7, 8,9]

However, drugs greatly help to eradicate binge eating episodes especially in conjunction with psychotherapy and other treatment methods. A few scientific studies propose a multidisciplinary treatment approach to binge eating disorder [5, 10]

There are different classes of medication used in the treatment of binge eating disorder. These include antidepressants, anticonvulsants, and anti-obesity drugs. [11, 12]

Psychotropic medicine especially antidepressants and antipsychotics are substantially used in binge eating disorder to treat comorbid symptoms with Fluoxetine, escitalopram, and aripiprazole the most popular. [13]

Drugs used in the treatment of binge eating disorder

Lisdexamfetamine dimesylate (Vyvanse)

 Vyvanse (lisdexamphetamine) is at present the only FDA-approved medication for the treatment of binge eating disorder. It is particularly recommended for moderate and severe BED in adults at 50 to 70 mg daily. [14, 15]  

The medical condition of persons under the prescription of Vyvanse like blood chemistry, bone health, toxicology and GI conditions must be adequately monitored. [5]

There is inadequate data regarding the success rate of Vyvanse in adults with mild binge eating episodes or teens and elderly with associated comorbid behaviors like moodiness and fretfulness. [16] Vyvanse is not a weight loss treatment option.

Common side effects of Vyvanse are sleeplessness, increased heart rate, dry mouth, jittery feelings, constipation, and nervousness. However, it can lead to more serious side effects like:

·              Psychiatric problems

·              Heart complications which include sudden death in people with heart disease or heart defects, 

·              Stroke and heart attack in adults

·              Psychotic or manic symptoms like: Phantasm, manic disorder, even in individuals without previous history of psychotic illness. [15]

Antipsychotic medications

Antipsychotic medications like Anxiolytics and mood stabilizer lithium carbonate are only a recommended treatment option for binge eating when the patient has associated psychotic symptoms.

A study found that Psychostimulant medications utilized in the management of ADHD to target the dopamine system and control behavior also help to in management of binge eating. [2]

A study by McCann and Agras found that desipramine reduces binge-eating episodes, binge eating associated with stress and helps to curb appetite. Another

McCann and Agras also found that tricyclic antidepressants are useful at reducing short-term binge-eating episodes.

Anticonvulsant medications

Studies found that anticonvulsant medications like topiramate and  zonisamide can suppress appetite which leads to binge eating [11]

 

Antidepressant medications

Studies show that antidepressant drugs that belong to the class of the selective serotonin reuptake inhibitor (SSRI) class like fluoxetine,

fluvoxamine, sertraline, citalopram or escitalopram helps to reduce binge eating episodes. The risk associated with them is also minimal. [5, 16, 11]

Antidepressants should be carefully prescribed starting with small initial doses and a gradual dosage increase. Toxic serum concentrations may build up at comparatively small doses. Thus, the dosage levels must be adequately monitored from time to time. [17]

Selective serotonin reuptake inhibitors

Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) may be helpful. A trial study on SSRI treatment of binge-eating found that fluvoxamine reduces binge-eating episodes but has no effect on depressive symptoms comorbidity [18]

Its associated side effects are insomnia, nausea, and abnormal dreams. [18]

A trial study show that a combination of fluoxetine and phentermine, a dopamine discharging agent with cognitive behavioral therapy proved more successful as treatment of binge eating than treatment with only cognitive behavioral therapy. [18]

SSRIs are good short-term treatment options for persons with binge eating habit. [18]

D-Fenfluramine

D-Fenfluramine has serotonergic effects and that it serves as an excellent is an appetite suppressant and is a short-term highly efficient treatment of an acute binge-eating disorder. However, it is a risk factor to valvular abnormalities [18]

Naltrexone

A study found that Naltrexone when combined with fluoxetine or psychotherapy significantly helps to reduce episodes of binge eating which implies that opiate obstruction is a potential clinical treatment for binge-eating disorder. [18]

Oxcarbazepine

Research conducted by the psychiatry Department of Neurosciences, University of Turin, Italy found that oxcarbazepine is especially great at eradicating perceptible impetuous binge eating.

Oxcarbazepine as well helps to the related psychological effects of binge eating like in mood, anger, and disruptive behavior. However, the study proposes using Oxcarbazepine together with other forms of treatment instead of exclusively. [19]