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Psychopharmacologic Treatment of Eating Disorders: Emerging Findings

  • Eating Disorders (C Grilo, Section Editor)
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Abstract

Psychopharmacologic treatment is playing a greater role in the management of patients with eating disorders. In this paper, we review randomized, placebo-controlled trials (RCTs) conducted in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other eating disorders over the past 3 years. Fluoxetine remains the only medication approved for an eating disorder, that being BN. RCTs of antipsychotics in AN have had mixed results; the only agent with some evidence of efficacy is olanzapine. One study suggests dronabinol may induce weight gain in AN. Preliminary studies suggest lack of efficacy of alprazolam, dehydroepiandrosterone, or physiologic estrogen replacement in AN; erythromycin in BN; and the opioid antagonist ALKS-33 in BED. In BED with obesity or overweight, bupropion may cause mild weight loss without seizures, and chromium may improve glucose regulation. Also in BED, three RCTs suggest the stimulant prodrug lisdexamfetamine may reduce binge eating episodes, and another RCT suggests intranasal naloxone may decrease time spent binge eating. There remains a disconnection between the size of eating disorders as a public health problem and the lack of pharmacotherapy research of these conditions.

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Acknowledgments

The authors would like to acknowledge Genie Groff for the manuscript preparation.

Compliance with Ethics Guidelines

ᅟ

Conflict of Interest

Anna I. Guerdjikova and Nicole Mori declare that they have no conflict of interest.

Susan L. McElroy is a consultant to, or member of the scientific advisory boards, and/or a principal or co-investigator on research studies sponsored by Agency for Healthcare Research & Quality (AHRQ), Alkermes, Bracket, Cephalon, F. Hoffman-La Roche Ltd., Forrest Laboratories, Marriott Foundation, MedAvante, National Institutes of Mental Health, Naurex, Novo Nordisk, Orexigen Therapeutics, Shire, Sunovion, and Takeda Pharmaceutical Company.

She is also the inventor on United States Patent No. 6,323,236 B2, Use of Sulfamate Derivatives for Treating Impulse Control Disorders, and, along with the patient’s assignee, University of Cincinnati, Cincinnati, OH, has received payment from Johnson & Johnson Pharmaceutical Research & Development, L.L.C., which has exclusive rights under the patent. Filed February 18, 2000; approved November 27, 2001.

Paul E. Keck, Jr. is a consultant to, or member of the scientific advisory boards, and/or a principal or co-investigator on research studies sponsored by Alkermes, Forest, Cephalon, Marriott Foundation, National Institute of Mental Health (NIMH), Shire, and Sunovion.

He is also the inventor on United States Patent No. 6,387,956: Shapira NA, Goldsmith TD, Keck, PE Jr. (University of Cincinnati) Methods of treating obsessive-compulsive spectrum disorder comprises the step of administering an effective amount of tramadol to an individual. Filed March 25, 1999; approved Mary 14, 2002.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Lindner Center of HOPE, Mason, OH, USA

    Susan L. McElroy, Anna I. Guerdjikova, Nicole Mori & Paul E. Keck Jr.

  2. Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH, USA

    Susan L. McElroy, Anna I. Guerdjikova, Nicole Mori & Paul E. Keck Jr.

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  1. Susan L. McElroy
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  2. Anna I. Guerdjikova
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  3. Nicole Mori
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Correspondence to Susan L. McElroy.

Additional information

At time of publication, lisdexamfetamine had recently received approval by the FDA for the treatment of moderare to severe BED in adults.

This article is part of the Topical Collection on Eating Disorders

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McElroy, S.L., Guerdjikova, A.I., Mori, N. et al. Psychopharmacologic Treatment of Eating Disorders: Emerging Findings. Curr Psychiatry Rep 17, 35 (2015). https://doi.org/10.1007/s11920-015-0573-1

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