Fluvoxamine in the treatment of binge-eating disorder: a multicenter
placebo-controlled, double-blind trial
by
Hudson JI, McElroy SL, Raymond NC, Crow S,
Keck PE Jr, Carter WP, Mitchell
JE, Strakowski SM,
Pope HG Jr, Coleman BS, Jonas JM
Biological Psychiatry Laboratory,
McLean Hospital, Belmont, MA 02178, USA.
jhudson@hsph.harvard.edu
Am J Psychiatry 1998 Dec; 155(12):1756-62
ABSTRACT
OBJECTIVE: The purpose of this study was to assess the efficacy of
fluvoxamine in the treatment of binge-eating disorder. Binge-eating disorder is
a newly described eating disorder characterized by recurrent episodes of binge
eating but without purging behaviors. Uncontrolled reports have suggested that
serotonin selective reuptake inhibitors (SSRIs) may be effective in treating
this disorder. METHOD: Eighty-five outpatients with a DSM-IV diagnosis of
binge-eating disorder were randomly assigned to receive either fluvoxamine
(N=42) or placebo (N=43) in a 9-week, parallel-group, double-blind, flexible
dose (50-300 mg) study at three centers. The primary outcome measures were
frequency of binge eating, expressed as log ([binges/week]+1), and Clinical
Global Impression (CGI) scale ratings. Secondary measures included the level of
response (based on the percentage change in frequency of binges), body mass
index, and Hamilton Rating Scale for Depression score. Except for the level of
response, the outcome measures were analyzed by random regression methods; the
treatment-by-time interaction was the measure of treatment effect. RESULTS:
Compared with placebo, fluvoxamine was associated with a significantly greater
rate of reduction in the frequency of binges, rate of reduction in CGI severity
scores, rate of increase in CGI improvement scores, level of response for
patients who completed the 9-week study, and rate of reduction in body mass
index. There was no significant difference between placebo and fluvoxamine
groups in the rate of decrease in Hamilton depression scale scores. A
significantly greater proportion of patients receiving fluvoxamine than those
receiving placebo discontinued treatment because of an adverse medical event.
CONCLUSIONS: In this placebo-controlled trial, fluvoxamine was found to be
effective according to most outcome measures in the acute treatment of
binge-eating disorder.
SSRIs
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