Lindner Center of HOPE, 4075 Old Western Row Road, Mason, OH 45040, USA.
Expert Opin Pharmacother. 2012 Oct;13(14):2015-26. doi: 10.1517/14656566.2012.721781. Epub 2012 Sep 4.
Growing evidence indicates binge eating, defined as the consumption of an abnormally large amount of food accompanied by a sense of loss of control, is an important public health problem. Although psychotherapy may be effective, not all patients respond adequately.
This article provides an overview of bulimia nervosa (BN) and binge eating disorder (BED), the two conditions characterized by recurrent binge eating as a core feature, and reviews studies of specific medications in treating patients with BN or BED, focusing on randomized controlled trials (RCTs).
Although the evidence base is small, growing data indicate pharmacotherapy may be helpful for some patients with BN or BED. Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), are modestly effective for reducing binge eating over the short term in BN and BED. SSRIs may be modestly effective in BN over the long term. Topiramate has consistently been shown to decrease binge eating in BED and BN, but side effects may limit its usefulness. Single RCTs suggest zonisamide and atomoxetine may be effective in BED. Combination therapy may be required for optimal outcomes. It is not yet known whether the binge eating of BN and BED respond similarly to pharmacotherapy.
越来越多的证据表明，暴食症（定义为在失去控制感的情况下，摄入异常大量的食物）是一个重要的公共卫生问题。尽管心理疗法可能有效，但并非所有患者都能得到充分的反应。
本文概述了神经性贪食症（BN）和暴食障碍（BED）这两种以反复暴食为核心特征的病症，并回顾了治疗 BN 或 BED 患者的特定药物研究，重点是随机对照试验（RCT）。
尽管证据基础较小，但越来越多的数据表明，在 BN 或 BED 患者中，药物治疗可能有帮助。抗抑郁药，特别是选择性 5-羟色胺再摄取抑制剂（SSRIs），在 BN 和 BED 中短期治疗暴食症的效果适度。SSRIs 在 BN 中可能在长期内有适度的效果。托吡酯一直被证明能减少 BED 和 BN 中的暴食症，但副作用可能限制了其应用。单一 RCT 表明左乙拉西坦和阿托莫西汀可能对 BED 有效。为了达到最佳效果，可能需要联合治疗。目前尚不清楚 BN 和 BED 的暴食症是否对药物治疗有相似的反应。
