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Progress in Developing Pharmacologic Agents to Treat Bulimia Nervosa
Susan L McElroy1,2, Anna I Guerdjikova3,4, Nicole Mori3
1Lindner Center of HOPE, Mason, OH, USA. susan.mcelroy@lindnercenter.org.
CNS Drugs
|December 8, 2018
Summary
Current pharmacologic treatments for bulimia nervosa (BN) offer modest benefits. Research is exploring new agents, but no drugs are specifically developed for BN yet, suggesting repurposing existing medications may be necessary.
Area of Science:
- Pharmacology
- Psychiatry
- Neuroscience
Background:
- Bulimia nervosa (BN) is a significant eating disorder with limited pharmacologic treatment options.
- Existing treatments primarily include antidepressants and topiramate, offering modest efficacy.
Purpose of the Study:
- To review current and past pharmacologic agents for bulimia nervosa (BN).
- To identify medications undergoing empirical study for BN and preclinical candidates.
- To suggest future research directions in BN pharmacotherapy.
Main Methods:
- Literature searches and clinical trial registry reviews for BN, binge eating disorder (BED), and preclinical models.
- Evaluation of drug classes including antidepressants, antiepileptics, stimulants, opioid antagonists, and weight loss agents.
Main Results:
- Antidepressants (SSRIs) and topiramate show modest efficacy in BN.
- Ongoing studies involve fluoxetine, other serotonergic antidepressants, naloxone, lisdexamfetamine, phentermine-topiramate, ethinyl estradiol/drospirenone, and prazosin.
- Preclinical research suggests potential for nociceptin receptor antagonists, lorcaserin, monoamine stabilizers, and orexin-1 receptor antagonists.
Conclusions:
- No drugs are currently developed specifically for bulimia nervosa.
- Repurposing centrally acting drugs with psychotropic effects or appetite suppression may be a viable strategy.
- Further research is needed to develop targeted pharmacotherapies for BN.
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