Zonisamide in the treatment of binge eating disorder with obesity: A randomized controlled trial

Psychopharmacology Research Program, Department of Psychiatry, University of Cincinnati College of Medicine, OH 45267-0559, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.14). 12/2006; 67(12):1897-906. DOI: 10.4088/JCP.v67n1209
Source: PubMed

ABSTRACT Binge eating disorder (BED) is associated with obesity. Zonisamide is a novel antiepileptic drug associated with weight loss. The purpose of this study was to evaluate zonisa-mide in the treatment of BED associated with obesity.
In this 16-week, single-center, randomized, double-blind, placebo-controlled, flexible-dose (100-600 mg/day) trial, 60 outpatients with DSM-IV-TR BED received zonisamide (N = 30) or placebo (N = 30). The primary outcome measure was weekly frequency of binge eating episodes. The primary analysis of efficacy was a longitudinal analysis of the intent-to-treat sample, with treatment-by-time interaction as the effect measure. Patients were enrolled from September 5, 2003, through October 1, 2004.
Compared with placebo, zonisamide was associated with a significantly greater rate of reduction in binge eating episode frequency (p = .021), body weight (p < .001), BMI (p = .001), and scores on the Clinical Global Impressions-Severity scale (p < .001), Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating (p < .001), and Three Factor Eating Questionnaire disinhibition scales (p < .001). Plasma ghrelin concentrations increased with zonisamide but decreased with placebo (p = .001). The mean (SD) zonisamide daily dose at endpoint evaluation was 436 (159) mg/day. Twelve patients (N = 8 receiving zonisamide, N = 4 receiving placebo) discontinued because of adverse events. The most common reasons for discontinuing zonisamide were accidental injury with bone fracture (N = 2), psychological complaints (N = 2), and cognitive complaints (N = 2).
Zonisamide was efficacious, but not well tolerated, in the short-term treatment of BED associated with obesity. identifier NCT00221442.

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    • "The broad pharmacodynamic properties of zonisamide suggest that they have potential effects on other neuropsychiatric disorders. Several clinical trials have investigated the effectiveness of zonisamide on migraines (Ashkenazi et al., 2006; Drake et al., 2004), chronic pain (Krusz, 2003), bipolar affective disorder (Berigan, 2002; Ghaemi et al., 2008; McElroy et al., 2005; Wang et al., 2008), binge eating disorder (McElroy et al., 2006), and obesity(Gadde et al., 2003; McElroy et al., 2006; Wang et al., 2008; Yang et al., 2010). "
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    • "After extensive studies it became available in 1989 for the treatment of intractable epilepsy in Japan and received over 10 years later approval in the USA and Europe for adjunctive treatment of partial seizures in adults (Murata, 2004). Besides treatment of epilepsy, there has been a growing interest in the therapeutic potential of zonisamide for treating non-seizure conditions, such as intractable neuropathic pain (Atli and Dogra, 2005), headache (Drake et al., 2004), obesity and binge eating disorder (McElroy et al., 2006) and Parkinson's disease (PD) (Murata et al., 2001). Particular in PD, studies reporting positive effects of zonisamide have become more frequent. "
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