Treatment of nocturnal eating syndrome and sleep-related eating disorder with topiramate.
BACKGROUND
Sleep-related eating disorder (SRED) and nocturnal eating syndrome (NES) combine features of sleep disorders and eating disorders. Treatment of these nocturnal eating behaviors has been directed towards underlying identifiable sleep or eating disorders using dopaminergic or opioid agonists, as well as anorectic agents, at times with the addition of sedatives.


METHODS
Two patients with SRED and two with NES, who had failed multiple previous trials of pharmacotherapy and psychotherapy, were treated in a naturalistic, open-label fashion with topiramate at night. Reduction in nocturnal eating was graded based on self-report. Weight was computed at the outset of, and during, topiramate treatment.


RESULTS
One patient with NES had a complete elimination of nocturnal eating with topiramate, two patients (one with NES, one with SRED) had a marked response, and one patient (with SRED) had a moderate response. Mean dose was 218 mg, though three patients noted an improvement at 100 mg. Notable weight loss was observed in all patients (mean of 11.1 kg). Benefits of topiramate treatment have been maintained for a mean period of 8.5 months.


CONCLUSIONS
Topiramate may be of benefit for patients with NES or SRED in reducing nocturnal eating, improving nocturnal sleep, and producing weight loss.
Divisions of Psychiatry and Sleep Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02459, USA. jwinkelman@sleephealth.com
John W
JW
Winkelman
D000328:Adult; D019440:Anti-Obesity Agents / Q000008:administration & dosage*; D020920:Dyssomnias / Q000188:drug therapy*; D001068:Feeding and Eating Disorders / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077236:Topiramate; D016896:Treatment Outcome; D015431:Weight Loss
D019440:Anti-Obesity Agents; D000077236:Topiramate; D005632:Fructose