Table 2.
Synopsis of emerging treatments for binge-eating episodes in Bulimia Nervosa and Binge-Eating Disorder
| Intervention | Classification | Proposed mechanism of action | Supporting evidence |
|---|---|---|---|
| CCK | Gut neurohormone | Increases satiety | Reduced post-prandial levels in BN, clinical study of CCK receptor agonist on-going |
| GLP-1 | Gut neurohormone | Increases satiety | Reduced post-prandial levels in BN, liraglutide FDA-approved for weight loss, clinical study on-going in BN and BED |
| PYY | Gut neurohormone | Increases satiety | Reduced post-prandial levels in BN |
| Topiramate | Antiepileptic | Suppresses appetite | Mono-therapy associated with weight loss in obesity, combination with phenteramine reduced binge-eating in a case series, clinical study on-going |
| Zonisamide | Antiepileptic | Suppresses appetite | Reduces binge-eating in BED in 1 RTC and in BN in 1 open-label pilot study |
| Naltrexone, nalmefene | Mu-opioid antagonist | Suppresses appetite | Naltrexone-bupropion combination FDA approved for weight loss, nalmefene improves BED in a case report, clinical studies on-going |
| tDCS | Neuromodulation | Modulates excitation of cortical regions | Positive effects 1 case series in BED and 1 RCT in BN |
| rTMS | Neuromodulation | Stimulation or depression of cortical regions | Positive effects in 4 small studies, 1 failed RCT in BN |
| Lorcaserin | Neurotransmission | Agonist of serotonin 2C receptor | FDA approved for weight loss, reduces binge-episodes in mouse model of binge-eating |
| Erythromycin | Antibiotic | Prokinetic agent | Clinical study on-going |
| Memantine | Neurotransmission | Modulates signaling on NMDA receptor | Clinical study on-going |
| Baclofen | Neurotransmission | GABA-B receptor agonist | Clinical study on-going |
Abbreviations: CCK cholecystokinin, GLP-1- glucagon-like peptide 1, PYY polypeptide YY, tDCS transcranial direct current stimulation, rTMS repetitive transcranial magnetic stimulation, RTC randomized controlled trial