Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan.
J Clin Psychopharmacol. 2020 Nov/Dec;40(6):599-606. doi: 10.1097/JCP.0000000000001284.
Zinc plays an important role in appetite regulation. L-Carnosine, an endogenous dipeptide, may also regulate eating behavior via its histaminergic and antiglutamatergic properties. Polaprezinc (zinc-L-carnosine complex) is a medication for gastric ulcers. A small case series reported successful treatment of binge eating with add-on polaprezinc.
This was an open trial of add-on polaprezinc in patients with binge eating disorder (BED; n = 22) or bulimia nervosa (BN; n = 7) receiving antidepressants. A 4-week baseline period was followed by a 16-week polaprezinc treatment at 150 mg/d (containing 34 mg zinc and 116 mg L-carnosine) in addition to ongoing psychotropic medications. We also assessed their zinc status via a laboratory index and zinc deficiency-related symptoms.
At the study end, both conditions showed a significant reduction in the 4-week frequency of combined objective and subjective binge eating episodes, the 4-week frequency of days when at least 1 such episode occurred (only in BED), several aspects of eating disorder psychopathology (rated by the Eating Disorder Examination-Questionnaire), and comorbid depressive symptoms (rated by the 16-item Quick Inventory of Depressive Symptomatology [Self-Report]). Serum copper/zinc ratio decreased from 1.4 to 1.1 on average in both conditions. All patients had multiple zinc deficiency-related symptoms at baseline that substantially improved after polaprezinc treatment. Overall, the effectiveness of polaprezinc was greater in BED patients than in BN patients, with minor adverse effects.
These findings offer preliminary evidence for the effectiveness of polaprezinc in treating BED and BN and suggest the involvement of zinc deficiency in these conditions.
锌在食欲调节中起着重要作用。L-肉碱,一种内源性二肽,也可能通过其组胺能和抗谷氨酸能特性调节进食行为。聚赖氨酸锌(锌-L-肉碱复合物)是一种治疗胃溃疡的药物。一项小型病例系列报告称,添加聚赖氨酸锌可成功治疗暴食症。
这是一项针对暴食障碍(BED;n=22)或贪食症(BN;n=7)患者的添加聚赖氨酸锌的开放性试验,这些患者正在服用抗抑郁药。在基线期 4 周后,在继续使用精神药物的基础上,添加聚赖氨酸锌治疗 16 周,剂量为 150mg/d(含 34mg 锌和 116mg L-肉碱)。我们还通过实验室指标和锌缺乏相关症状评估了他们的锌状态。
研究结束时,两种情况的 4 周联合客观和主观暴食发作频率、至少 1 次此类发作发生的 4 周天数(仅在 BED 中)、饮食障碍心理病理学的几个方面(由饮食障碍检查问卷评定)和共病抑郁症状(由 16 项简明抑郁症状清单[自我报告]评定)均有显著降低。两种情况的血清铜/锌比值平均从 1.4 降至 1.1。所有患者在基线时有多种锌缺乏相关症状,在聚赖氨酸锌治疗后均有明显改善。总的来说,聚赖氨酸锌在 BED 患者中的疗效优于 BN 患者,且不良反应较小。
这些发现为聚赖氨酸锌治疗 BED 和 BN 的有效性提供了初步证据,并提示锌缺乏可能与这些疾病有关。