High-dose escitalopram in the treatment of binge-eating disorder with obesity: a placebo-controlled monotherapy trial

Authors

  • Anna I. Guerdjikova,

    Corresponding author
    1. Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
    • Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, PO Box 670559, 231 Albert Sabin Way, Cincinnati, OH 45267-0559, USA.
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  • Susan L. McElroy,

    1. Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • Renu Kotwal,

    1. Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • Jeffrey A. Welge,

    1. Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • Erik Nelson,

    1. Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • Katie Lake,

    1. Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • David D' Alessio,

    1. Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
    2. Mental Health Service Line and General Clinical Research Center, Cincinnati Veteran Affairs Medical Center, Cincinnati, Ohio, USA
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  • Paul E. Keck Jr,

    1. Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
    2. Mental Health Service Line and General Clinical Research Center, Cincinnati Veteran Affairs Medical Center, Cincinnati, Ohio, USA
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  • James I. Hudson

    1. Department of Psychiatry, Harvard Medical School and Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts, USA
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Abstract

Objective

The purpose of this study was to evaluate the efficacy and safety of high-dose escitalopram in the treatment of binge-eating disorder (BED) associated with obesity.

Method

Forty-four outpatients with BED by DSM-IV criteria and obesity were randomized to receive either escitalopram (N = 21) or placebo (N = 23) in a 12-week, double-blind, flexible dose (10–30 mg/day) study.

Results

In the primary analysis, escitalopram (mean dose 26.5 mg/day) and placebo had similar rates of reduction of binge episodes, binge days and obsessive-compulsive symptoms of BED. However, escitalopram was associated with statistically significant reductions in weight, body mass index (BMI), and global severity of illness scores. In a secondary analysis, escitalopram was associated with statistically significant reductions in frequency of binge episodes and binge days, weight, BMI and severity of illness, but not in obsessive-compulsive symptoms of BED. No changes in metabolic variables, including measures of ghrelin and leptin, were observed. High-dose escitalopram was well tolerated.

Conclusion

High-dose escitalopram was not efficacious in reducing obsessive-compulsive symptoms of BED, but was efficacious in reducing weight and global severity of illness. No definitive conclusions about its efficacy in reducing binge-eating frequency could be drawn due to limitations related to statistical power. Copyright © 2007 John Wiley & Sons, Ltd.

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