Current pharmacotherapy options for bulimia nervosa and binge eating disorder

@article{McElroy2012CurrentPO,
  title={Current pharmacotherapy options for bulimia nervosa and binge eating disorder},
  author={Susan L. McElroy and Anna I. Guerdjikova and Nicole Mori and Anne M. O'Melia},
  journal={Expert Opinion on Pharmacotherapy},
  year={2012},
  volume={13},
  pages={2015 - 2026}
}
Introduction: Growing evidence indicates binge eating, defined as the consumption of an abnormally large amount of food accompanied by a sense of loss of control, is an important public health problem. Although psychotherapy may be effective, not all patients respond adequately. Areas covered: This article provides an overview of bulimia nervosa (BN) and binge eating disorder (BED), the two conditions characterized by recurrent binge eating as a core feature, and reviews studies of specific… 

Psychopharmacologic Treatment of Eating Disorders: Emerging Findings

RCTs of antipsychotics in AN have had mixed results; the only agent with some evidence of efficacy is olanzapine; one study suggests dronabinol may induce weight gain in AN; and preliminary studies suggest lack of efficacy of alprazolam, dehydroepiandrosterone, or physiologic estrogen replacement in AN.

Psychopharmacological Options in the Multidisciplinary and Multidimensional Treatment of Eating Disorders

Although EDs are relatively frequent psychiatric disorders in the general population, especially in adolescent and juvenile age groups, evidence based on the scientific evidence of the efficacy of the pharmacological treatment of EDAs remains modest.

ICBT for Eating Disorders

Research suggests that treatment adherence is lower in BN patients who are younger and show more dietary restraint and lower BMI at baseline, and evidence for the cost-effectiveness of ICBT programmes is as yet limited.

Binge eating disorder: from clinical research to clinical practice.

Growing evidence from the fields of psychopathology and neurobiology converges to support the idea that "overeating" has much in common with other behavioral addictions, and substance abuse treatment agents may show promise for the treatment of BED.

Pharmacological manipulations in animal models of anorexia and binge eating in relation to humans

Evidence for the efficacy of monoaminergic treatments for anorexia nervosa is limited, while more support exists for the treatment of BN or BED with Monoaminergic drugs.

Managing comorbid obesity and depression through clinical pharmacotherapies

The relationship between obesity and mood disorders; the effects of psychotropic medications commonly used in mood disorders on body weight; the psychiatric effects of available anti-obesity medications; and the few treatment studies of medications in obese patients with mood disorders or depressive symptoms are outlined.

Emotional profile of female rats showing binge eating behavior

The Combination of Levomilnacipran, Cognitive Behavior Therapy and Christian Based Self –Help Group in the Treatment of Bulimia Nervosa: A Case Report

A case of 33 year old female with chronic bulimia nervosa, who favorably responded to the combination of a Cognitive behavior therapy and Christian based self –help group and the serotonin norepinephrine reuptake inhibitor antidepressant levomilnacipran which has only been approved for the treatment of major depressive disorder.

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The most effective approach to treating binge eating disorder is likely psychotherapy combined with medication management as indicated, and for antidepressants, bringing about lasting weight loss appears to be difficult.

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

The rationales and data supporting the effectiveness of specific medications or medication classes in treating patients with BED are reviewed, and the role of pharmacotherapy in the BED treatment armamentarium is discussed, suggesting future areas for research.

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The hypothesis that fluvoxamine is well tolerated and effective in reducing binge-eating crises and purging episodes in patients with BN is supported.

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Examining the relationship between initial and later response to fluoxetine, the only antidepressant medication approved by the US Food and Drug Administration for the treatment of BN, with the goal of developing guidelines to aid clinicians in deciding when to alter the course of treatment found no reliable relationships between pretreatment characteristics and eventual response to pharmacotherapy.

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Topiramate was well tolerated, with neurologic side effects the most common, and may be an effective treatment for binge-eating disorder.

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It is confirmed that sertraline is well tolerated and effective in reducing binge-eating crises and purging in patients with BN.

Psychological treatments for bulimia nervosa and binging.

The efficacy of CBT and particularly CBT-BN in the treatment of people with bulimia nervosa and also related eating disorder syndromes was supported, and other psychotherapies were also efficacious, particularly interpersonal psychotherapy in the longer-term.

Evidence-based pharmacotherapy of eating disorders.

Meta-analyses on efficacy of pharmacotherapy for BN and BED support moderate effect sizes for medication, but generally low recovery rates, and combined treatment with pharmacotherapy and cognitive behaviour therapy has been more effective than either alone.

Pharmacological interventions for binge eating: lessons from animal models, current treatments, and future directions.

Overall, each of these neurotransmitter systems provides a promising avenue for new pharmacotherapy development for binge eating, and preclinical and human studies provide a strong rationale for the development of highly-selective drugs that target this neurocircuitry.

Role of Antiepileptic Drugs in the Management of Eating Disorders

In conclusion, AEDs have an emerging role in the management of some eating disorders and topiramate appears to have the broadest spectrum of action as an anti-binge eating, anti-purging and weight loss agent.
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