You are looking to learn more about possible drug solutions to treat the binge eating disorder? You are in the right place: find out what the anti binge medications more prescribed and what advantages and disadvantages they can express.
In fact, to date, no drugs have been developed specifically to treat symptoms of binge eating disorder (BED - Binge eating disorder).
Currently prescribed "anti-binge" drugs have been "converted" (as they were intended to treat other health conditions), probably because the neurobiology of eating disorders is not yet well understood.
Furthermore, there is only a limited amount of evidence regarding the effects of these drugs on BED sufferers. A major problem with researching these drugs is that BED sufferers with coexisting psychiatric disorders are typically excluded from it.
Iqbal and Rehman (2019), two researchers specializing in the BED, point out that about the 79% of those who suffer from binge eating they are also affected by coexisting psychiatric disorders (more or less relevant), such as for example anxiety or depression.
This means that the results of many of these studies may not be extensible to most people with BED.
ANTIDEPRESSANTS DRUGS IN UNCONTROLLED FEEDING DISORDER
Because many individuals with BED have coexisting mood disorders, doctors often prescribe antidepressants.
Antidepressants include selective inhibitors of serotonin reuptake (SSRIs) such as fluoxetine (or Prozac), citalopram and sertraline.
- Antidepressants reduce the symptoms of anxiety and depression and can therefore improve mood.
- Antidepressants can indirectly reduce the compulsion to overeat in BED sufferers by improving their mood. However, these results are conflicting.
- Antidepressants are not addictive.
- Researchers, Ahsan and colleagues (2020), list many common side effects for one of the most popular antidepressants: la fluoxetine. These include insomnia, anxiety, drowsiness, nausea, disorders gastrointestinal, dryness of the jaws, headache and decreased sexual desire.
- Fluoxetine poses potential risks to unborn babies and needs more research. Therefore, the US Food and Drug Administration (FDA) has assigned fluoxetine a pregnancy category C.
AMPHETAMINE (LISDEXAMPHETAMINE DIMESILATE) IN UNCONTROLLED FEEDING DISORDER
Lisdexamfetamine, (or “Vyvanse”), belongs to the amphetamine family. It was originally intended for reduce the impulsive behavior experienced by those who suffer from attention deficit hyperactivity disorder (ADHD).
- A review of the studies by Bello and Yeomans (2018) found that lisdexamfetamine can reduce pulse and frequency of bingeing, as well as reduce weight.
- Researchers say it can improve attention (as it does for ADHD sufferers - attention deficit hyperactivity disorder).
- Bello and Yeomans warn that lisdexamfetamine has a high inducing potential addiction and abuse. For this reason, it is a Schedule II controlled substance in both the United States and the United Kingdom.
- Other reported side effects include: dryness of the jaws, headache, insomnia, anxiety, decreased appetite, gastrointestinal disorders, nausea and nervousness. When taken for prolonged periods it can also increase heart rate and blood pressure.
- The risks of lisdexamphetamine to unborn babies are unknown and therefore it belongs to the FDA (US Food and Drug Administration) pregnancy category C.
- Brownley and colleagues (2016) found that lisdexamphetamine reduces the feeling of appetite in people with BED. This can make it potentially harmful to binge-eating sufferers as it interrupts hunger and satiety signals.
ANTICONVULSIVE DRUGS IN UNCONTROLLED FEEDING DISORDER
Doctors sometimes prescribe anticonvulsant drugs such as topiramate for BED, although they usually prescribe it for Seizures.
- Studies by McElroy and colleagues (2003; 2007) found that topiramate can reduce the pulses and frequency of binge eating, as well as reducing weight and BMI (body mass index).
- Brownley and colleagues found that topiramate led to increased weight loss in participants compared to lisdexamfetamine.
- McElroy and colleagues state that topiramate side effects may include paraesthesia (tingling or burning sensations in the hands and feet, upper respiratory tract infection, dry mouth, nausea, sleepiness, and problems with memory and concentration).
- The FDA warns that topiramate can induce suicidal thoughts and increase the risk of suicide.
- The FDA has assigned topiramate a pregnancy category C because of its potential risks to unborn babies.
- Topiramate reduces the sensation of appetite and therefore can be harmful in the long term for those suffering from BED.
PSYCHOTHERAPY, DRUGS, OR A COMBINATION OF THESE?
The National Institute for Clinical Excellence (NICE) of the United Kingdom recommends cognitive behavioral therapy (TCC) as the best treatment for BED. So far, TCC has been the most sought after therapy for binge eating, so it is better known than other types of therapy.
NICE does not recommend using drugs as the only treatment for binge eating disorder due to a lack of research on their long-term effects.
On the other hand, Brownley and colleagues say there is strong evidence to support the combination of therapist-led TCC and lisdexamphetamine or antidepressants.
The researchers say they found modest evidence to support the combination of self-made TCC (without the help of a therapist) and drugs, but found the lack of long-term monitoring research "alarming".
Research suggests that antidepressants, lisdexamphetamine, and topiramate are generally effective and safe to use for binge-eating sufferers. However, organizations such as the UK's National Center for Eating Disorders actively discourage the use of drugs such as lisdexamfetamine.
They claim that the fact that it is addictive makes it unsuitable for those suffering from BED, as they already struggle with impulse control issues.
I drugs they can also give many unpleasant side effects and experts point out that the long-term consequences on patients are still unknown.
Another major concern is that lisdexamfetamine and topiramate reduce the sensation of appetite and further confuse the cues of hunger and satiety in BED sufferers.
Without having these signals restored, their relationship with food is unlikely to heal, and long-term recovery is less likely.
More traditional therapies and methods of self-help they allow patients to recover their natural physical cues and heal their relationship with food.
Until we know a lot more about the long-term consequences of anti binge medications, an approach more holistic therapeutic it could be more sure and more wise.
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