Safety of pharmacotherapy options for bulimia nervosa and binge eating disorder

ABSTRACT

Introduction: Eating disorders represent a set of psychiatric illnesses with lifelong complications and high relapse rates. Individuals with eating disorders are often stigmatized and clinicians have a limited set of treatments options. Pharmacotherapy has the potential to improve long term compliance and patient commitment to treatment for eating disorders.

Areas covered: This review will examine the efficacy and safety profile of the FDA-approved medications for the treatment of bulimia nervosa (BN) and binge eating disorder (BED). This will include the evaluation of fluoxetine for BN, and lisdexamfetamine for BED. Safety information will be review from randomized control trials (RCT), open label trials, and case reports.

Expert opinion: Fluoxetine for BN and lisdexamfetamine for BED are relatively safe and well-tolerated. Despite these properties, these two medications represent a limited arsenal for the pharmacological treatment of eating disorders. Thus, more research-based strategies are needed to develop safe, effective, and more targeted therapies for eating disorders.

KEYWORDS:

• Prozac
• bulimic
• loss of control
• therapeutic
• vyvanse

Article highlights

• Medications for the maintenance of eating disorders, bulimia nervosa (BN) and binge eating disorder (BED), are limited.

• Fluoxetine for BN and lisdexamfetamine for BED are the only FDA-approved medications.

• Insomnia was the most common treatment-emergent adverse event (TEAE) reported with fluoxetine in BN patients.

• Dry mouth, headache, and insomnia, are the most TEAE with lisdexamfetamine in BED. Lisdexamfetamine is also a schedule II DEA controlled medication associated with elevations in heart rate and blood pressure with long term treatment.

• Both medications are generally safe and well-tolerated.

• More medications are needed to treat eating disorders, specifically anorexia nerovosa and other eating pathologies.

This box summarizes key points contained in the article.

Declaration of interest

NT Bello is funded by an NIH grant and a Shire Grant. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper has not been funded.