title: Lamotrigine use in patients with binge eating and purging, significant affect dysregulation, and poor impulse control.
abstract: OBJECTIVE
  Some patients with symptoms of binge eating and purging are successfully treated with specific serotonin reuptake inhibitors (SSRIs), but others experience only partial or no benefit. Significant affect dysregulation and poor impulse control may be characteristics that limit responsiveness.
  
  
  METHODS
  We report on the treatment of five patients with bulimia nervosa (BN), anorexia nervosa-binge/purge type (AN-B/P) or eating disorder not otherwise specified (EDNOS), using the anticonvulsant lamotrigine after inadequate response to SSRIs.
  
  
  RESULTS
  Following addition of lamotrigine to an antidepressant in four cases, and switch from an antidepressant to lamotrigine in one case, patients experienced substantial improvement in mood reactivity and instability, impulsive drives and behaviors, and eating-disordered symptoms.
  
  
  CONCLUSIONS
  These findings raise the possibility that lamotrigine, either as monotherapy or as an augmenting agent to antidepressants, may be useful in patients who binge eat and purge, and have significant affect dysregulation with poor impulse control.
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, California.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Trunko
authors.forename: Terry A
authors.initials: TA
authors.lastname: Schwartz
authors.forename: Enrica
authors.initials: E
authors.lastname: Marzola
authors.forename: Angela S
authors.initials: AS
authors.lastname: Klein
authors.forename: Walter H
authors.initials: WH
authors.lastname: Kaye
mesh_terms: D000293:Adolescent; D000339:Affect / Q000187:drug effects; D000856:Anorexia Nervosa / Q000188:drug therapy*; D000927:Anticonvulsants / Q000627:therapeutic use*; D056912:Binge-Eating Disorder / Q000188:drug therapy*; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000188:drug therapy*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000188:drug therapy* / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000077213:Lamotrigine; D017367:Selective Serotonin Reuptake Inhibitors; D014227:Triazines
keywords: anorexia nervosa; anticonvulsants; binge eating; bulimia nervosa; dangerous behavior; eating disorder; impulsive behavior; lamotrigine; self-destructive behavior; self-injurious behavior