Citalopram in the treatment of binge-eating disorder: a placebo-controlled trial

• Published in: The journal of clinical psychiatry Vol. 64; no. 7; p. 807
• Main Authors: McElroy, Susan L, Hudson, James I, Malhotra, Shishuka, Welge, Jeffrey A, Nelson, Erik B, Keck, Jr, Paul E
• Format: Journal Article
• Language: English
• Published: United States 01.07.2003
• Subjects: Adolescent; Adult; Body Mass Index; Bulimia - diagnosis; Bulimia - drug therapy; Citalopram - therapeutic use; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Double-Blind Method; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Obesity - diagnosis; Obesity - psychology; Outcome Assessment (Health Care); Serotonin Uptake Inhibitors - therapeutic use; Severity of Illness Index; Surveys and Questionnaires; Time Factors; Titrimetry
• ISSN: 0160-6689
• DOI: 10.4088/JCP.v64n0711

Binge-eating disorder is a newly recognized eating disorder characterized by recurrent episodes of binge eating without compensatory weight loss behaviors. It commonly co-occurs with depressive disorders and obesity. Citalopram is a highly selective serotonin reuptake inhibitor antidepressant. The purpose of this study was to assess the efficacy and safety of citalopram in the treatment of binge-eating disorder. Thirty-eight outpatients with a DSM-IV diagnosis of binge-eating disorder were enrolled in the study between August 2000 and July 2001 and were randomly assigned to receive either citalopram (N = 19) or placebo (N = 19) in a 6-week, double-blind, flexible-dose (20-60 mg/day) study. The primary measure of efficacy was frequency of binge-eating episodes. Secondary measures included frequency of binge days, body mass index (BMI), weight, Clinical Global Impressions-Severity of Illness scale scores, Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating (YBOCS-BE) scores, Hamilton Rating Scale for Depression (HAM-D) scores, and response categories. The outcome measures were analyzed using 2 random regression methods, with a time trend analysis (primary analysis) and an endpoint analysis. In addition, response categories were analyzed using an exact trend test. Compared with placebo-treated subjects, subjects receiving citalopram (mean dose of 57.9 mg/day) had a significantly greater rate of reduction in frequency of binge eating (p =.003), frequency of binge days (p <.001), BMI (p <.001), weight (p <.001), severity of illness (p =.028), and YBOCS-BE score (p =.007) and a marginally significant rate of reduction in HAM-D score (p =.053). Differences between groups in response categories were marginally significant (p =.068 for intent-to-treat analysis). In a 6-week, placebo-controlled, flexible-dose trial, citalopram was efficacious in reducing binge-eating frequency, weight, and severity of illness and was generally well tolerated in subjects with binge-eating disorder.