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


METHODS
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.


CONCLUSIONS
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.
Division of Psychopharmacology Research, Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267-0559, USA. guerdja@ucmail.uc.edu
Anna I
AI
Guerdjikova
Susan L
SL
McElroy
Renu
R
Kotwal
Jeffrey A
JA
Welge
Erik
E
Nelson
Katie
K
Lake
David D'
DD
Alessio
Paul E
PE
Keck
James I
JI
Hudson
D000293:Adolescent; D000328:Adult; D052018:Bulimia Nervosa / Q000139:chemically induced / Q000188:drug therapy*; D015283:Citalopram / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D013997:Time Factors
D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors