Mental Health Unit, Distretto 24, ASL Napoli 1 Centro, Naples, Italy.
J Pharm Pharmacol. 2012 Jan;64(1):2-10. doi: 10.1111/j.2042-7158.2011.01353.x. Epub 2011 Sep 27.
The purpose of this review is to outline the nosographic characteristics of NES and the most reliable ethiopathogenetic theories in relation to the most recent evidence in the literature.
The night eating syndrome (NES) is a disorder occurring at the stated time, that does not meet the criteria for any specific eating disorder. NES is characterized by a reduced feeding during the day, evening hyperphagia accompanied by frequent nocturnal awakenings associated with conscious episodes of compulsive ingestion of food and abnormal circadian rhythms of food and other neuroendocrine factors. Frequently it is associated with obesity and depressed mood. We highlight the therapeutic possibilities of some drugs, especially selective serotonin re-uptake inhibitors (SSRIs), which reduce the hyperactivity of the serotonin transporter in NES and significantly improve the clinical picture of this disease.
Night eating syndrome is of importance clinically because of its association with obesity. The recognition and effective treatment of NES may be an increasingly important way to treat a subset of the obese population. Treatment of the syndrome, however, is still in its infancy. One clinical trial has reported efficacy with the SSRI sertraline. Other treatments, such as the anticonvulsant topiramate, phototherapy, and other SSRIs, may also offer future promise. Particularly useful would be studies involving brain scans (magnetic resonance imaging or single-photon emission computed tomography) of patients with NES compared with the healthy population, to investigate more thoroughly the possible alterations involved in the pathogenesis of NES.
本文旨在概述夜间进食综合征(NES)的发病特点及最可靠的病因学理论,并结合文献中最新证据进行阐述。
夜间进食综合征是一种特定时间发生的障碍,不符合任何特定进食障碍的标准。NES 的特征是白天进食减少,傍晚暴食,常伴有频繁的夜间觉醒,伴有意识状态下强迫性摄食和食物及其他神经内分泌因素昼夜节律异常。NES 常与肥胖和情绪低落有关。我们强调了一些药物的治疗可能性,特别是选择性 5-羟色胺再摄取抑制剂(SSRIs),它们可以降低 NES 中 5-羟色胺转运体的过度活跃,并显著改善这种疾病的临床症状。
NES 与肥胖有关,因此在临床上很重要。识别和有效治疗 NES 可能是治疗肥胖人群的一个越来越重要的方法。然而,该综合征的治疗仍处于起步阶段。一项临床试验报告了 SSRIs 舍曲林的疗效。其他治疗方法,如抗惊厥药托吡酯、光疗和其他 SSRIs,也可能有未来的应用前景。特别有用的是,对 NES 患者进行脑扫描(磁共振成像或单光子发射计算机断层扫描)与健康人群进行比较的研究,以更深入地研究 NES 发病机制中可能涉及的改变。