A 12 to 24 weeks pilot study of sertraline treatment in obese women binge eaters

Department of Neurosciences, Psychiatry Section, Turin University, and Centre for Eating Disorders, Az. Ospedaliera San Giovanni Battista di Torino, Italy.
Human Psychopharmacology Clinical and Experimental (Impact Factor: 2.19). 04/2006; 21(3):181-8. DOI: 10.1002/hup.758
Source: PubMed


Previous studies tested the efficacy of sertraline in Binge Eating Disorder (BED) over a period of 6 weeks. The present open study assesses the efficacy of sertraline over a period of 24 weeks in obese persons with binge eating behaviour (with or without the full criteria for BED) confirmed by high scores on the Binge Eating Scale (BES). Thirty-two obese outpatients (14 with BED and 18 without full criteria for BED), without co-occurring psychiatric comorbidities, were treated with sertraline (dose range 100-200 mg/d). Subjects were assessed at baseline and at 8, 12 and 24 weeks of treatment for number of binges, weight and psychopathology. After 8 weeks of treatment a significant improvement in the BES score and a significant weight loss emerged. These results were maintained over 24 weeks. A moderate drop out rate was detected, but no significant association with the severity of side effects was found. Further studies are needed to confirm the usefulness of sertraline in the treatment of patients with BED and also in binge eaters with a less severe eating psychopathology.

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    • "This category of patients is probably subject to the same hazards to health and well-being as those who satisfy all the criteria for BED. Although these patients constitute a large proportion of overweight patients who fail several diet regimens and attend visits with nutritionists and eating disorders centers, indications about the role of psychopharmacological treatment in this population are just beginning to emerge.23 "
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    ABSTRACT: Topiramate is an anticonvulsant drug used for the treatment of epilepsy and prophylaxis of migraine. Some authors have proposed its use as a mood stabilizer and have reported its efficacy in reducing impulsiveness and improving mood regulation, possibly via its antagonism to glutamatergic transmission in the lateral hypothalamus, although this indication is still controversial. Weight loss is a side effect consistently reported in the medical literature in patients treated with topiramate. Given its potential role in stabilizing mood and reducing impulse control problems and weight, topiramate has been proposed as a treatment for obese patients with binge eating disorder (BED). The aim of this paper is to review published data on the efficacy and safety of topiramate for the treatment of obese subjects with BED. Although the evidence is preliminary, topiramate appears to be a relatively safe and effective treatment for obese subjects with BED. Limitations of the studies and future directions for research are discussed.
    Neuropsychiatric Disease and Treatment 02/2009; 5(1):385-92. · 1.74 Impact Factor
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    • "global severity, and a greater rate of clinical improvement compared with placebo in a 6-week trial (McElroy et al., 2000). A recent open trial seems to confirm the effectiveness of sertraline at a longer followup (Leombruni et al., 2006a). Finally also citalopram (McElroy et al., 2003) and escitalopram (Guerdjikova et al., 2008) seem to be effective in reducing weight and global severity of illness in obese subjects with BED. "
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    ABSTRACT: Previous studies support the use of selective serotonin reuptake inhibitors (SSRIs), in overweight patients with Binge Eating Disorder (BED), but results are far from conclusive. Sertraline has been studied less extensively, and there have been a few studies concerning SSRIs that report follow-up data at more than 12 weeks of follow-up. The present study assesses the effectiveness of sertraline and fluoxetine over a period of 24 weeks in obese patients with BED (DSM-IV-TR). Forty-two obese outpatients were randomized and assigned to one of two different drug treatments: 22 were treated with sertraline (dose range: 100-200 mg/day) and 20 with fluoxetine (dose range: 40-80 mg/day). Subjects were assessed at baseline and at 8, 12, and 24 weeks of treatment for binge frequency, weight loss, and severity of psychopathology. No significant differences were found between the two treatments. After 8 weeks of treatment a significant improvement in the Binge Eating Scale score and a significant weight loss emerged. These results were maintained by responders (weigh loss of at least 5% of baseline weight) over 24 weeks. The results suggest that a 6-month treatment with SSRI may be an effective option to treat patients with BED.
    Progress in Neuro-Psychopharmacology and Biological Psychiatry 07/2008; 32(6):1599-605. DOI:10.1016/j.pnpbp.2008.06.005 · 3.69 Impact Factor
    • "Based on two reviews of the pharmacotherapy literature, there is limited evidence that medication and placebo differentially affect either binge eating or weight loss in patients with BED (Grilo 2007, NICE 2004). Since that time, four trials have found benefit over placebo using two antiobesity drugs [sibutramine (Appolinario et al. 2003, Leombruni et al. 2006), atomoxetine (McElroy et al. 2007)] and an anticonvulsive medication [topiramate (Kotwal et al. 2003)]. "
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    ABSTRACT: Binge eating disorder (BED) was introduced in 1994 as a provisional eating disorder diagnosis. The core symptom is recurrent binge eating in the absence of inappropriate compensatory behaviors and/or extreme dietary restraint. This review examines the status of the literature on BED according to five criteria that have been proposed to determine whether BED warrants inclusion in the psychiatric nosology as a distinct eating disorder. We conclude that each of these criteria was met. There is a commonly accepted definition of and assessment approach to BED. The clinical utility and validity of BED have been established, and BED is distinguishable from both bulimia nervosa and obesity. BED should be included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
    Annual Review of Clinical Psychology 02/2008; 4(1):305-24. DOI:10.1146/annurev.clinpsy.4.022007.141149 · 12.67 Impact Factor
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