A paradigm for facilitating pharmacotherapy at a distance: sertraline treatment of the night eating syndrome.
OBJECTIVE
To test a novel method of facilitating pharmacotherapy at a distance and assess the effectiveness of sertraline for the treatment of night eating syndrome (NES).


METHODS
The effectiveness of the selective serotonin reuptake inhibitor sertraline in the treatment of NES was assessed at a distance. NES is characterized by a delay in the circadian rhythm of food intake, with evening hyperphagia and/or nighttime awakenings and ingestions. Persons who contacted us through our Web site, e-mail, or telephone for help with their NES completed a Night Eating Questionnaire and received a semistructured interview (Night Eating Syndrome History and Inventory) to determine the presence of NES. Fifty such persons received treatment with sertraline from their own physicians, to whom we offered consultation. Participants completed questionnaires every 2 weeks for 8 weeks and received a final telephone interview to assess their progress. Outcomes were compared with those from an earlier face-to-face open-label trial of sertraline. The study was conducted from September 2003 to May 2005.


RESULTS
Both the questionnaires and interviews showed improvements in 5 key aspects of NES: the general Night Eating Symptom Scale, evening hyperphagia, nighttime awakenings, nocturnal ingestions, and the Beck Depression Inventory (all p < .001), and the mean body weight of the 41 overweight and obese subjects, reported by survey, fell 3.0 kg (p = .01). These results are similar to those obtained in an earlier face-to-face trial of sertraline with NES.


CONCLUSIONS
The study confirmed the effectiveness of sertraline in the treatment of NES and introduced a paradigm for facilitating pharmaco-therapy at a distance.
Stunkard
Albert J
AJ
Department of Psychiatry Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, Philadelphia, USA. stunkard@mail.med.upenn.edu
Allison
Kelly C
KC
Lundgren
Jennifer D
JD
Martino
Nicole S
NS
Heo
Moonseong
M
Etemad
Bijan
B
O'Reardon
John P
JP
D001835:Body Weight; D002032:Bulimia / Q000188:drug therapy; D002940:Circadian Rhythm; D004435:Eating / Q000502:physiology; D034742:Electronic Mail; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D006963:Hyperphagia / Q000188:drug therapy; D020407:Internet; D007407:Interviews as Topic; D009765:Obesity / Q000188:drug therapy; D010555:Personality Inventory / Q000706:statistics & numerical data; D019114:Remote Consultation / Q000379:methods*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline