Antidepressant medicines for binge eating disorder

Antidepressant medicines may reduce episodes of binge eating in those who have binge eating disorder, and they may help with related depression or anxiety.

It may take several weeks for antidepressants to relieve symptoms associated with binge eating disorder, although they may become effective sooner. You may need to continue taking antidepressants over a long period of time to prevent a relapse.1

Antidepressants that may be used to treat binge eating disorder include:2, 3

  • Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, for example) or fluvoxamine (Luvox).
  • Tricyclics, such as imipramine (Tofranil) or desipramine (Norpramin).
  • Atypical antidepressants such as bupropion (Wellbutrin, for example) or trazodone.

Antidepressants regulate brain chemicals that control mood. They can help reduce the compulsive behavior that leads to binging. These drugs can also help people who have both depression and binge eating disorder.

Antidepressants may produce some bothersome, but often temporary, side effects depending on the type of antidepressant.

Selective serotonin reuptake inhibitors (SSRIs)

These medicines help reduce binging and may also help people who are obese to lose weight.4

Studies show that SSRIs may be less bothersome than other antidepressants, such as tricyclics. SSRIs have less serious side effects and are less dangerous in case of an overdose. Although side effects of SSRIs are usually mild, they can include nausea, loss of appetite, diarrhea, anxiety, irritability, problems sleeping or drowsiness, loss of sexual desire or ability, headaches, dizziness, and dry mouth. After several weeks of treatment, SSRI side effects may be less or may go away completely.

Be sure to tell your doctor about all the medicines and herbal preparations you are currently taking.

Tricyclic antidepressants

Tricyclic side effects can include stomach upset, constipation, dry mouth, blurred vision, and drowsiness. Some people gain weight and have problems with sexual desire and ability. Tricyclics are started in low doses and gradually increased to avoid overdose and other serious side effects.

Be sure to tell your doctor about all the medicines and herbal preparations you are currently taking. Tricyclic antidepressants can have serious interactions with other medicines, including those used to treat seizures, such as phenytoin (Dilantin, for example), or certain heart medicines, such as digoxin (for example, Lanoxin).

Atypical antidepressants

Bupropion and trazodone have different side effects than tricyclic antidepressants. They have side effects similar to those of SSRIs and may have additional side effects.

Possible side effects of bupropion include weight loss, agitation, confusion, nervousness, and anxiety. In rare cases, bupropion can cause other serious side effects, such as allergic reactions, heart palpitations, and seizures.

Possible side effects of trazodone include drowsiness, dizziness or lightheadedness, blurred vision, weight gain, dry mouth, constipation, headache, and nausea.

What to think about

You may start to feel better within 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about your medicines, or if you do not notice any improvement by 3 weeks, talk to your doctor.

Tell your doctor about every medicine or supplement (prescription or over-the-counter) you are taking before starting an antidepressant. Some antidepressants can have serious interactions with other medicines or dietary supplements.

FDA Advisory. The U.S. Food and Drug Administration (FDA) has issued an advisory to patients, families, and health professionals to closely monitor children and adults taking antidepressants for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.

Citations

  1. Steering Committee on Practice Guidelines, American Psychiatric Association (2006). Treating Eating Disorders: A Quick Reference Guide. Arlington, VA: American Psychiatric Publishing.
  2. Yager J, et al. (2006). Practice Guideline for the Treatment of Patients With Eating Disorders, 3rd ed. Arlington, VA: American Psychiatric Association. Also available online: http://www.psychiatryonline.com/pracGuide/loadGuidelinePdf.aspx?file=EatingDisorders3ePG_04-28-06.
  3. Carter WP, et al. (2003). Pharmacologic treatment of binge eating disorder. International Journal of Eating Disorders, 34(Suppl): S74–S88.
  4. Abramowicz M (2008). Diet, drugs, and surgery for weight loss. Treatment Guidelines From The Medical Letter. 6(68): 23–28.

Last Updated: September 16, 2009

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