Antiepileptic Drugs Playing Role in Managing Eating Disorders

CINCINNATI—Several antiepileptic drugs are playing an emerging role in management of some eating disorders, according to researchers at the University of Cincinnati (UC) and the Lindner Center of HOPE.

Paul Keck Jr., MD, Susan McElroy, MD, and Lindner Center research investigators Anna Guerdjikova, PhD, and Brian Martens recently co-authored a review article for CNS Drugs that provided an overview of eating disorders, the rationale for using antiepileptic drugs (AEDs) in the treatment of eating disorders and a review of the data supporting the effectiveness of specific AEDs in the treatment of patients with eating disorders.

Keck is president and CEO of the Lindner Center of HOPE, a mental health facility in Mason, Ohio, that is affiliated with the UC College of Medicine. McElroy is chief research officer. Additionally, Keck and McElroy are professors in UC’s psychiatry department.

The authors surveyed the literature for available first- and second-generation AEDs in the treatment of all recognized and potential eating disorders via an online database search of health and medical journals from January 1966 to April 2008.

One particular AED, topiramate, appears to have the broadest spectrum of action as an anti-binge eating, anti-purging and weight loss agent, the authors found, and may also have beneficial effects in night-eating syndrome and sleep-related eating disorder.

Many AEDs have effects on neural systems that are important in regulating eating and weight control, the authors say. Topiramate, along with zonisamide and felbamate, are associated with weight loss and decreased appetite.

In randomized, placebo-controlled trials, topiramate was found to be effective in the treatment of bulimia nervosa and binge-eating disorder, and zonisamide was found to be effective in the treatment of binge-eating disorder. In addition, carbamazepine was effective for bulimia nervosa and phenytoin for binge/compulsive eating.

Further studies are needed, the authors say, to clarify which specific agents may be most useful to various patient groups. In addition, future AEDs—particularly those with effects on appetite and weight—should be considered as potential therapeutic agents for eating disorders.