Binge eating disorder treatment

When is medication indicated in the treatment of psychiatric illness There is no short answer to this question. At one end of the continuum, patients with schizophrenia and other psychotic disorders, bipolar disorder, and severe major depressive disorder should always be considered candidates for pharmacotherapy, and neglecting to use medication, or at least discuss the use of medication with these patients, fails to adhere to the current standard of mental health care. Less severe depressive disorders, many anxiety disorders, and binge eating disorders can respond to psychotherapy and/or pharmacotherapy, and different therapies can target distinct symptom complexes in these situations. Finally, at the opposite end of the spectrum, adjustment disorders, specific phobias, or grief reactions should generally be treated with psychotherapy alone. 

The current SSRIs in the United States inclnde fluoxetine, fluvoxamine, sertraline (Zoloft), paroxetine (Paxil), citalopram (Celexa), and escitalopram (Lexapro). All effectively treat major depression. In addition, one or more of the SSRIs has been shown effective in the treatment of dysthymic disorder, the depressive phase of bipolar disorder, premenstrual dysphoric disorder, panic disorder, social phobia, obsessive-compnlsive disorder, bnlimia nervosa, and binge-eating disorder. 

Husted DS, Shapira NA. Binge-eating disorder and new pharmacologic treatments. Primary Psychiatry 2005 12 46-51. 

I Unlabeled Uses Treatment of binge eating disorder, bipolar disorder, obesity... 

Arnold LM, McElroy SL, Hudson JI, Welge JA, Bennett AJ, Keck PE (2002) A placebo-controlled, randomized trial of fluoxetine in the treatment of binge-eating disorder. J Clin Psychiatry 63 1028-1033... 

Malhotra S, King KH, Welge JA, Brusman-Lovins L, McElroy SL (2002) Venlafaxine treatment of binge-eating disorder associated with obesity a series of 35 patients. J Clin Psychiatry 63 802-806... 

Shapira NA, Goldsmith TD, McElroy SL (2000) Treatment of binge-eating disorder with topiramate a clinical case series. J Clin Psychiatry 61 368-372... 

Appolinario, J. C. and S. L. McElroy (2004). Pharmacological approaches in the treatment of binge eating disorder. CurrDrug Targets 5(3) 301-7. 

McElroy, S. L., R. Kotwal, J. I. Hudson, E. B. Nelson and P. E. Keck (2004). Zonisamide in the treatment of binge-eating disorder an open-label, prospective trial. J Clin Psychiatry 65(1) 50-6. 

Wilfley, D. E., M. A. Friedman, J. Z. Dounchis, R. I. Stein, R. R. Welch and S. A. Ball (2000). Comorbid psychopathology in binge eating disorder relation to eating disorder severity at baseline and following treatment. J Consult Clin Psychol 68(4) 641-9. 

Wilfley, D. E., R. R. Welch, R. I. Stein, E. B. Spurrell, L. R. Cohen, B. E. Saelens, et al. (2002). A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder. Arch Gen Psychiatry 59(8) 713-21. 

Carter WP, Hudson 11, Lalonde JK, et al. Pharmacologic treatment of binge eating disorder. Int J Eat Disord 2003 34 S74—S88. 

McElroy SL, Casuto LS, Nelson EB, et al. Placebo-controlled trial of sertraline in the treatment of binge eating disorder. Am J Psychiatry 2000 157 1004-1006. 

Hudson J, McElroy SL, Raymond NC, et al. Fluvoxamine in the treatment of binge eating disorder A multicenter, placebo-controlled, double-blind trial. Am J Psychiatry 1998 155 1756-1762. 

McElroy SL, Arnold LM, Shapira NA, et al. Topiramate in the treatment of binge eating disorder associated with obesity A randomized, placebo-controlled trial. Am J Psychiatry 2003 160 255-261. 

Appolinario JC, Bacaltchuk J, Sichiera R et al. A randomized, double blind, placebo-controlled study of sibutramine in the treatment of binge-eating disorder. Arch Gen Psychiatry 2003 60 1109-1116. 

Guerdjikova AI, McElroy SL, Welge JA, Nelson E, Keck PE, Hudson JI. Lamotrigine in the treatment of binge-eating disorder with obesity a randomized, placebo-controlled monotherapy trial. Int Clin Psychopharmacol 2009 24(3) 150-8. 

Anticonvulsdnts. An early observation that BN patients may have abnormal electroencephalogram (EEG) resnlts led to specnlation that binge eating may represent an atypical behavioral presentation of seiznre activity. Thus, the first controlled medication study for the treatment of BN evaluated the use of the antiseizure medication phenytoin (Dilantin). Phenytoin was not found to be significantly superior to placebo, and the earlier reports of EEG abnormalities were not confirmed. The results of a subsequent trial of carbamazepine (Tegretol), an anticonvulsant that has been reported to be effective in the treatment of bipolar disorder, were also disappointing. As a result, anticonvulsants are not routinely used in the treatment of BN. 

Fairburn, C.G. and Cooper, Z. (1993) The Eating Disorder Examination, 12th ed. In Fairburn, C.B. and Wilson, G.T., eds. Binge Eating Nature, Assessment, and Treatment. New York Guilford Press, pp. 317-360. 

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