Although psychotherapies are effective in treatment of BED, not all patients respond to these therapies. It is important to understand that psychotherapies are not effective in reducing obesity, diabetes, hypertension and other co-morbid mental disorders like bipolar or depression that are associated with BED. Bariatric surgery may reduce binge eating; however there is no confirmed evidence of its efficacy.
Recently some clinical trials have tried to examine and there are few that are underway to examine the effects of medications in BED. However, to date there are no medications that are specifically prescribed or approved by FDA for the treatment of BED. Medications that show effects on moods, appetite, and weight are generally considered of therapeutic benefits in BED.
Antidepressants drugs, such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and serotonin-norepinephrine reuptake inhibitors (SNRIs) may be helpful.
Since obesity is the major complication seen in people who have BED, anti-obesity agents might be of a great therapeutic value in these patients.
Antiepileptic drugs that are normally used to control seizures have also been found to reduce binge-eating episodes.
Novel Drugs under Development for BED
New drugs that hold promise for BED include some of those in development for obesity and mood disorders.
Clinical studies have reported that lorcaserin is associated with significant weight loss and improved maintenance of weight loss. Lorcaserin has received an approval by the Food and Drug Administration (FDA) as a potential new treatment option for the medical management of overweight and obesity in June 2012.
Lisdexamfetamine dimesylate (LDX, Vyvanse®)
Recently, results from a study funded by Shire Development LLC revealed that lisdexamfetamine dimesylate (LDX, Vyvanse®) at the dosage of 50 and 70 mg per day, showed significant reduction in binge-eating episodes. The drug also improved binge-eating behavior in adults with moderate to severe BED. The findings were presented at the 166th Annual meeting of American Psychiatric Association conducted in May 2013.
Opioid Antagonist Naloxone
Some people get addicted to certain types of food, which release endorphins (foods high in salt, sugar and fat), similar to those who get addicted to drugs that release endorphins (exogenous opiates like morphine). According to scientists opioidergic system may be responsible for a subtype of obesity, which is associated with BED.
The scientists therefore conducted a phase II trial, to assess the efficacy, safety, and tolerability of intranasal naloxone in 127 adults suffering BED. The scientists found that 2 mg of nasal naloxone taken before each binge significantly reduce the time spent in binging compared to the placebo.
Naloxone is not an appetite suppressant nor does it prevent the body from absorbing fat. Naloxone reduces the binge eating behavior by blocking opioidergic system, which otherwise releases endorphins. This study was presented recently at the 166th Annual meeting of American Psychiatric Association.