Department of Psychology, Drexel University, Philadelphia, PA, USA.
Curr Pharm Des. 2011;17(12):1180-7. doi: 10.2174/138161211795656774.
Binge eating behavior has been noted in some eating disorders as well as in obesity. The goal of this paper is to review current, non-serotonergic pharmaceutical approaches to treat binge eating. Further, using information derived from preclinical models, we discuss candidate neurotransmitter systems for study as targets for the treatment of binge eating. Dopaminergic circuits have been implicated in both laboratory animal models and human studies of binge eating, though existing medications specifically targeting the dopaminergic system have been found to have adverse side effects. Opioidergic and gamma-aminobutyric acid (GABA) systems also appear to be highly involved in aspects of binge eating; further, opioid antagonists, such as naloxone and naltrexone, and GABA agonists, such as baclofen, have all been shown to be effective in treating alcohol dependence and may be equally efficacious in attenuating binge eating. Preclinical evidence, and some clinical evidence, suggests that cannabinoid antagonism may also be useful in the treatment of binge eating, although the specific effect of antagonists, on binge consumption remains unclear. Overall, each of these neurotransmitter systems provides a promising avenue for new pharmacotherapy development for binge eating, and preclinical and human studies provide a strong rationale for the development of highly-selective drugs that target this neurocircuitry.
暴饮暴食行为在一些饮食失调和肥胖症中都有被注意到。本文的目的是回顾目前非血清素能的药物治疗方法，以治疗暴饮暴食。此外，我们还利用临床前模型中获得的信息，讨论了候选神经递质系统，作为治疗暴饮暴食的靶点。多巴胺能回路在实验室动物模型和人类暴饮暴食研究中都有涉及，尽管现有的专门针对多巴胺能系统的药物已被发现具有不良反应。阿片能和γ-氨基丁酸（GABA）系统似乎也与暴饮暴食的各个方面高度相关；此外，阿片拮抗剂，如纳洛酮和纳曲酮，以及 GABA 激动剂，如巴氯芬，都已被证明对治疗酒精依赖有效，并且可能同样有效地减轻暴饮暴食。临床前证据和一些临床证据表明，大麻素拮抗剂在治疗暴饮暴食方面也可能有用，尽管拮抗剂对暴饮暴食的具体影响仍不清楚。总的来说，这些神经递质系统中的每一个都为暴饮暴食的新药物治疗提供了一个有前途的途径，临床前和人体研究为开发针对这种神经回路的高选择性药物提供了强有力的理由。
