• Binge-eating disorder can be treated with several types of medication
    • Vyvanse (lisdextroamphetamine) is a stimulant
      • It is in the same illegal category as cocaine and morphine
      • Can be highly addictive if abused, though perhaps less-so than many other stimulants
      • Also used for ADHD and narcolepsy
    • Topomax (topiramate) is an anticonvulsant (used for preventing seizures)
    • Antidepressants, particularly the SSRIs
      • Also useful for anxiety
  • Drugs may not be effective in the treatment of anorexia nervosa.

  • For bulimia nervosa, medication may be useful
    • These are the same substances useful against anxiety and mood disorders
      • SSRI’s
    • Prozac (fluoxetine) is the only (SSRI) drug specifically licensed to treat bulimia nervosa
    • Medication tends to enhance the benefits of talk-therapy
    • Over the long-term, drugs alone do not have a significant, sustained effect
  • Obese people respond to food placed in front of them with increased activity in brain regions associated with finding food appetizing, and when eating, decreased activity in brain regions associated with reward
    • Medication used to treat obesity  work largely by affecting pathways in the hypothalamus
      • The hypothalamus has many roles
        • Releases hormones
        • Regulates body temperature
        • Maintains daily physiological cycles
        • Controls appetite
        • Manages sexual behavior
        • Regulates emotional responses
    • Wellbutrin (bupropion) is an antidepressant
      • Works similarly to Ritalin, but is not a controlled substance, and does not carry the significant abuse potential
      • Also used to help people quit smoking
      • If abused, seizures can result
    • Contrave (bupropion/naltrexone) adds naltrexone, which is used to combat alcohol and opiate addiction
      • Naltrexone is dosed lower than would be given to a drug addict for monotherapy (therapy involving one chemical)
      • This combination medication has been shown to produce more, and greater, results than either compound alone
    • Belviq (lorcaserin) was specifically developed for weight loss, under the theory that activating a specific subtype (region) of the serotonin recpetor, 5-HT2c, appetite decreases
    • Fastin (phentermine) is a stimulant medication approved as a monotherapy to treat obesity
      • Quite similar to the mechanism of methylphenidate, Fastin is a reuptake inhibitor of dopamine and norepinephrine
      • Abuse is a hazard
      • Increased blood pressure and pulse put strain on the cardiovascular system, which is already at risk for damage for those with obesity
      • Tolerance tends to develop, and people can become just as hungry as they were before
      • Weight loss tends to not be sustained
      • Short-term treatment may be most wise
      • This may be used to push through the most difficult, initial period
    • An extended-release formulation of Topomax (topiramate, an anticonvulsant) and phentermine, in one pill, Qsymia, can also be prescribed for obesity
      • The synergy of these two compounds allows the Fastin portion to be prescribed at as a little as a quarter of what it would be if just it were given
      • Topomax alleviates the possible anxiogenic (anxiety-producing) effect of Fastin by increasing GABA

Sources: Stahl’s Essential Psychopharmacology, Abnormal Psychology: An Integrative Approach, http://www.mayoclinic.org