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Pharmacotherapy of Binge-Eating Disorder

A Review

Goracci, Arianna MD; di Volo, Silvia MD; Casamassima, Francesco MD; Bolognesi, Simone PhD; Benbow, Jim MD; Fagiolini, Andrea MD

doi: 10.1097/ADM.0000000000000089
Review
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Objectives: The purpose of this article is to provide a comprehensive review of pharmacotherapy for binge eating disorder, including new therapeutic approaches such as centrally acting sympathomimetics, nootropics, lisdexamfetamine, and substance abuse treatment agents such as acamprosate, sodium oxybate, baclofen, and naltrexone.

Methods: The study was conducted by searching the MEDLINE database using the keywords “binge eating disorder,” “obesity,” and “pharmacological therapy.”

All available studies on each drug dating from 1988 to the present were considered, focusing mainly on randomized controlled trials (RCTs). Other types of studies were considered when no RCTs were found. We drafted separate tables for open-label studies (Table 1), RCT (Table 2), and retrospective studies (Table 3). Each study is detailed by the number of subjects, additional design considerations, doses, results, additional main comparators, and study limitations.

Results: The data emerging from this study seem to show that, at least in the short term, some specific medications within the classes of antidepressants, anticonvulsants, and antiobesity agents may prove promising in achieving the main objectives in the treatment of binge eating disorder: reducing the frequency of binge eating, reducing weight, and improving the associated psychopathology. The major limitation in interpreting these results is the short duration of the studies and the lack of adequately sized trials, or trials including patients with medical comorbidities.

Good results are being obtained with new combinations of drugs and with substance abuse treatment agents. Although the precise nature of the relationship between substance use disorders and binge eating disorder remains to be clarified, the evidence suggests that treatments recognized as effective for substance use disorders may be useful as novel treatments for binge eating disorder. This field of research remains open to future studies with more precise methodological approaches and more detailed parameter assessment; a multidisciplinary approach is also essential to better understand such a complex disease.

From the Division of Psychiatry (AG, SdV, SB, AF), Department of Molecular Medicine, University of Siena School of Medicine, Siena, Italy; Department of Psychiatry, Neurobiology, Pharmacology and Bio-technologies (FC), University of Pisa, Pisa, Italy; and University of Washington School of Social work (JB), Seattle, WA.

Send correspondence and reprint requests to Arianna Goracci, Psychiatry Division, Department of Molecular Medicine, University of Siena School of Medicine, Viale Bracci 1, Siena, Italy. E-mail: a.goracci@gmail.com.

The authors declare no conflicts of interest.

Received April 29, 2013

Accepted August 03, 2014

© 2015 American Society of Addiction Medicine