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

Author(s): Guerdjikova AI, McElroy SL, Kotwal R, Welge JA, Nelson E, Lake K, Alessio DD, Keck PE Jr, Hudson JI

Affiliation(s): Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0559, USA. guerdja@ucmail.uc.edu

Publication date & source: 2008-01, Hum Psychopharmacol., 23(1):1-11.

Publication type: Clinical Trial; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

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. (c) 2007 John Wiley & Sons, Ltd.