Pharmacological management of binge eating disorder: current and emerging treatment options

McElroy, Susan L.; Guerdjikova, Anna I.; Mori, Nicole; O’Melia, Anne

doi:10.2147/tcrm.s25574

Cited by 62 publications

(56 citation statements)

References 187 publications

(232 reference statements)

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“…3,[14][15][16] Antiepileptics also have been studied for BED, although they are associated with high rates of discontinuation. 3,17,18 The most extensively studied antiepileptic for BED, topiramate, has efficacy in BE and weight loss, but its use is limited by effects on cognition. 19 At present, no pharmacologic treatments for BED are approved by the US Food and Drug Administration.…”

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confidence: 99%

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Efficacy and Safety of Lisdexamfetamine for Treatment of Adults With Moderate to Severe Binge-Eating Disorder

et al. 2015

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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 PARTICIPANTSWe performed a randomized, 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 MEASURESWe 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 assessments 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 RELEVANCEThe 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 attentiondeficit/hyperactivity disorder. Further investigation of lisdexamfetamine in BED is ongoing. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01291173

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confidence: 99%

“…19 At present, no pharmacologic treatments for BED are approved by the US Food and Drug Administration. 3 Additional clinical trials are needed to identify effective pharmacotherapies. Pathologic overeating may be related to dysfunction of the dopamine (DA) and norepinephrine systems, as evidenced by genetic and pharmacologic findings and animal models.…”

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confidence: 99%

Efficacy and Safety of Lisdexamfetamine for Treatment of Adults With Moderate to Severe Binge-Eating Disorder

et al. 2015

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“…McElroy et al (2012) realizaron una extensa revisión sobre los diferentes tratamientos farmacológi-cos para tratar el ta y concluyeron que la mayoría de estos cuentan con limitaciones importantes, tales como el empleo de muestras pequeñas, una alta respuesta al placebo, altas tasas de abandono de los tratamientos y la dificultad que implica trasladar los resultados del laboratorio al mundo real. A pesar de las limitaciones enumeradas, estos autores consideran que existe suficiente evidencia acerca de una eficacia moderada de los antidepresivos en el tratamiento del ta a corto plazo, si bien estos fármacos no modifican el peso del paciente y se desconocen sus resultados a largo plazo.…”

Section: Tratamientos Farmacológicos Del Trastorno Por Atracónunclassified

“…En cuanto a los tratamientos farmacológicos para tratar el ta, si bien los estudios al respecto presentan importantes limitaciones (McElroy et al, 2012), -entre ellas la ausencia de datos sobre su eficacia a largo plazo (Reas y Grilo, 2014)-, parece que la utilización de algunos antidepresivos y antiepilép-ticos ha mostrado cierta utilidad a la hora de reducir los atracones y el peso, además de disminuir determinadas patologías comórbidas del paciente (Kimberly et al, 2015;Marazziti et al, 2012;McElroy et al, 2012;Ramacciotti et al, 2013;Reas y Grilo, 2014). Sin embargo, no hay evidencia empírica de que la intervención farmacológica por sí sola sea más eficaz que el tratamiento psicológico, ni de que esta mejore los resultados de la terapia psicológica cuando ambos se aplican conjuntamente (Brown y Keel, 2012;Kass, Kolko y Wilfley, 2013).…”

Section: Conclusionesunclassified

“…Teniendo en cuenta los datos proporcionados se podría concluir que si bien la farmacología puede tener un importante papel en el manejo del ta, en aquellos pacientes con otros trastornos psiquiátri-cos, o los que presentan una enfermedad crónica o intratable -especialmente en los que responden inadecuadamente a la psicoterapia-, los fármacos empleados en la actualidad para tratar el ta están lejos de ser los más adecuados si se tienen en cuenta las distintas evidencias, tal y como ya apuntaban McElroy et al (2012).…”

Section: Conclusionesunclassified

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Tratamientos actuales del trastorno por atracón

González-Calderón

Ormaechea-Alegre

2016

Pensando Psicol.

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ResumenIntroducción: a pesar de que el trastorno por atracón (ta) constituye un importante problema de salud, menos de la mitad de quienes lo padecen reciben tratamiento. Objetivo: revisar la literatura reciente sobre las intervenciones llevadas a cabo en casos de ta. Método: con el fin de llevar a cabo la presente revisión narrativa, se han consultado las bases de datos Pubmed, Medline y Scielo. Solo se eligieron artí-culos en revistas indexadas en la Web of Science. La literatura revisada corresponde a los artículos más citados publicados en el período temporal que abarca desde el 2010 hasta el 2015. Resultados y conclusiones: los resultados muestran que las intervenciones más utilizadas son las de índole psicológica, entre las cuales se destacan la terapia cognitivo-conductual y la terapia interpersonal, recomendada esta última en pacientes con patología más severa. La terapia de conducta de pérdida de peso es menos eficaz al no reducir los atracones, por lo que no constituye el tratamiento de elección. Aunque algunos antidepresivos y antiepiléticos han mostrado cierta utilidad para reducir los atracones, el peso y patologías comórbidas, no hay evidencia de que la intervención farmacológica por sí sola sea más eficaz que la psicológica, ni de que mejore los resultados de la segunda cuando ambos se aplican conjuntamente. The results show that the most commonly used interventions are those of psychological nature, including cognitive behavioral therapy and interpersonal therapy, the latter recommended in patients with a more severe pathology. The behavioral therapy for weight loss is less effective by not reducing binge eating; therefore, it is not the treatment of choice. Although some antidepressant and antiepileptic drugs have shown some utility in reducing binge eating, weight and comorbidities, there is no evidence that pharmacological intervention alone is more effective than psychological intervention, or that it improves the results of the latter when both are applied together.

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Psychopharmacology in the Treatment of Eating Disorders

Hay

Claudino

2015

The Wiley Handbook of Eating Disorders

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Pharmacological management of binge eating disorder: current and emerging treatment options

Cited by 62 publications

References 187 publications

Efficacy and Safety of Lisdexamfetamine for Treatment of Adults With Moderate to Severe Binge-Eating Disorder

Efficacy and Safety of Lisdexamfetamine for Treatment of Adults With Moderate to Severe Binge-Eating Disorder

Tratamientos actuales del trastorno por atracón

Psychopharmacology in the Treatment of Eating Disorders

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