Binge Eating Support

NMDA receptors are found on brain cells and nerve cells. They take up any glutamate that happens to be around. This process is believed to control certain types of learning and memory. It is also suspected that it influences binge eating behavior.

 

If the receptors take up too much glutamate, it can damage or even kill the brain/nerve cell. You can imagine what this does to your memory and learning abilities. 

 

But why would there be too much glutamate around? There are lots of theories on that, but the main two possibilities are:

 

(a)   The excess glutamate came from the body, or

(b)   There was too much glutamate because the person ate lots of it in her diet. 

 

Drugs in the class NMDA receptor antagonists block the receptors from taking up glutamate, protecting them from the damage or death that excess glutamate causes. It’s not yet clear whether blocking glutamate is how NMDA receptor antagonists help stop binges and compulsive eating.

 

Right now, the details are not known.  But there is some evidence that certain NMDA receptor antagonists can help people stop binge eating or compulsive eating.     

 

There are several substances that act as NMDA receptor antagonists, but the Alzheimer’s drug Namenda (memantine) seems to be the most realistic medication option for treating compulsive eating and binging. Below you will find more information on Namenda.

 

Other substances that are NMDA receptor antagonists include:

 

·         Ketamine- also known as Special K, is a dissociative drug some people use recreationally. Ketamine is an anesthetic used for animals. 

 

·         Amantidine- Amantidine, or Symmetrel, is a prescription drug used to treat Alzheimer’s and Parkinson’s. It is also used as an anti-viral. 

 

·         Dextromethorphan- This is a common ingredient in over-the-counter cough syrups.

 

·         Strattera- Also known as atomoxetine, Strattera is a prescription drug used to treat ADHD. See below for more info on Strattera for the treatment of BED.

 

·         Alcohol- Alcohol is an NMDA receptor antagonist.

 

·         Ibogaine- Ibogaine is a prescription medication that is a dissociative and is hallucinogenic. 

 

·         Magnesium- Magnesium is an NMDA receptor antagonist. Taking a bio-available magnesium supplement could help those with depression (magnesium deficiency is common and is associated with depression). Be careful to use a form of magnesium your body can absorb, such as magnesium citrate.

 

·         Nitrous oxide, or Laughing Gas- Nitrous oxide is an anesthetic often used by dentists.

 

·         PCP- Phencyclidine, more commonly known as PCP, is an illegal drug with dissociative and hallucinogenic properties.

 

·         Methoxydine- a designer drug that is a dissociative anesthetic. It is similar to ketamine. It is a sedative and is also a hallucinogenic.

 

·         Tiletamine- one of the main ingredients in Telazole, an anesthetic used on animals that is similar to ketamine. It is illegal for human use.

 

·         L-phenylalanine- a natural amino acid found in the body

 

 

Namenda

 

Memantine, sold under the brand name Namenda in the United States, is a prescription medication marketed as a treatment for Alzheimer’s disease.  It is in the class of drugs known as NMDA receptor antagonists.  Studies on memantine for binge eating appear promising- so far, they have shown that memantine significantly reduces binge eating.

 

Examples:

 

A 2008 study published in the International Journal of Eating Disorders describes a 12 week trial of memantine in treating binge eating disorder.  Memantine use was associated with reduced binge eating episodes, fewer binge days and a lowered severity of illness.

 

A study published in 2005 in Economics and Human Biology discusses its finding that taking memantine normalized eating patterns in five women with binge eating disorder.  The paper’s author believes high levels of glutamate in the subjects’ diets played a large role in their obesity.  He suggests that NMDA receptor antagonists, which block glutamate, such as memantine be used to treat obesity.

 

Another study, published in Amino Acids (February 2011) concluded that glutamate might be involved in the overconsumption of palatable food in rats.  It was concluded that glutamate neurotransmission should be investigated as a possible target for medications to treat obesity and disordered eating. As mentioned above, NMDA receptor antagonists block glutamate.   

 

This 2008 animal-based study published in European Neuropsychopharmacology found that the NMDA receptor antagonists memantine and MTEP (a research drug not currently available for purchase) decrease food consumption in an animal model of binge eating disorder. 

 

Strattera

 

Strattera, or atomoxetine, is an ADHD medication that is an NMDA receptor antagonist.

This study published in The Journal of Clinical Psychiatry reports that in their study, atomoxetine was effective in the short-term treatment of BED.

 

 

This study in the International Journal of Obesity had the same findings.

 

 

Anti-Convulsants

 

 

Anti-convulsants, sometimes called anti-seizure or anti-epileptic drugs, are a class of drug used to treat seizures.  Some anti-convulsants have been studied as a possible treatment for binge eating disorder or compulsive eating.

In a study published in The American Journal of Psychiatry, ten people who had compulsive eating were given the anti-convulsant medication diphenylhydantoin. For nine of them, the medication successfully stopped their compulsive eating behavior.

 

 

Topamax

 

Topiramate (brand name: Topamax) is an anti-convulsant medication.  In a study published in the American Journal of Psychiatry, topiramate significantly reduced binge frequency.

 

This is a case study involving topiramate and binge eating.

 

Topiramate affects multiple receptors and neurotransmitters, so exactly how it stops binge eating is unclear.

Other anti-convulsants have been shown to be useful against depression and binge eating problems, such as phenytoin. 

 

Phenytoin 

 

Phenytoin is an anti-convulsant prescription medication that has been around for decades. It has been shown to be useful in treating binge eating and depression.

 

Lamictal (Lamotrigine)

 

There is conflicting evidence on whether Lamictal could be used to treat binge eating.  

 

 

Zonegran (Zonisamide)

 

Zonisamide is an anti-convulsant prescription medication of the sulfonamide type. Sulfonamides are also called sulfa drugs. Although there are many, many useful medications that are sulfa drugs, your doctor should monitor you if you are taking a sulfa drug for the first time. The rate of allergic or negative reactions is higher than for other drugs.

 

A study published in the Journal for Clinical Psychiatry in 2004 showed that Zonisamide reduced binge eating. 

 

In this study published in The Journal of Clinical Psychiatry, Zonisamide was effective at reducing the frequency of binges, reducing body weight and BMI as well as lowering scores on questionnaires that measured the severity of their BED. The study included 60 people at the beginning, but 12 dropped out because of side effects they experienced while taking Zonisamide. This is not entirely surprising, since, as mentioned above, sulfa drugs tend to have higher rates of negative side effects. The side effects the drop-outs cited were cognitive difficulties, psychological difficulties and accidental bone fractures. 

 

 

 

Selective Serotonin Reuptake Inhibitors

 

 

Drugs in the class of medications called Selective Serotonin Reuptake Inhibitors (SSRI) have been studied to see if they could help in the treatment of binge eating. I mention a few of them below, but other SSRI’s may also have similar effects. Common SSRI’s include Prozac, Paxil, Zoloft, Effexor and Celexa.

 

 

Venlafaxine (Effexor)

 

In a study on binge eating disorder treated with Effexor published in The Journal of Clinical Psychiatry, most of the patients taking Effexor had 50% or better improvement in number of binge episodes, weight, mood and blood pressure.

 

 

Celexa

 

Celexa, or citalopram, is an anti-depressant medication that is in the SSRI class of drugs. It is used to treat major depression and is sometimes prescribed off-label for Obsessive Compulsive Disorder, panic disorder and agoraphobia.

 

According to this study in The Journal of Clinical Psychiatry, citalopram reduced binge eating behavior, severity of illness and weight/BMI.

 

 

 

 

Anti-Depressants (non-SSRI)

 

 

Bupropion (Wellbutrin)

 

Wellbutrin is an anti-depressant medication. There is some evidence that it helps reduce binging and encourages weight loss, but studies conflict on this point.

 

That said, many people with BED also have depression. For depression, Wellbutrin can be very effective. Lessening depression would likely lessen binge eating disorder symptoms as well, since many binges are caused by negative emotions. When someone with BED has less stress and/or decreased negative feelings, she will automatically tend to binge less. She will not have as many episodes of negative feelings to soothe.

 

Even though evidence for Wellbutrin’s effectiveness in BED is conflicting, many researchers are showing great interest in it for obesity drugs. For instance, a new medication on the market for obesity is Contrave, which is a combination of Wellbutrin and naltrexone.

 

 

Opiate Antagonists

 

Naltrexone + Bupropion (Proposed Name: Contrave)

 

Contrave is a new anti-obesity medication pending approval by the FDA. It is simply a combination of two older medications: bupropion and naltrexone.

 

Naltrexone, known by the brand names Revia and Depade, is a drug used to treat opiod dependence, but is much more commonly used for alcohol dependence. It works by blocking the opiod receptors cells, so whenever the user attempts to use opiates or drink alcohol, they won’t get the same pleasure from it that they used to. Without the reward of feeling good, the user will drink far less or even quit drinking all together.

 

There are theories that people addicted to food derive pleasure or a numb feeling because something binds to their opiod receptors. Naltrexone is believed to discourage binge eating and compulsive eating by taking the pleasure out of it.

 

While some of the preliminary evidence on naltrexone’s effectiveness in treating BED, compulsive eating and obesity looks promising, a possible downside has emerged. Patients are sometimes stopping the medication because they want food to feel good again. This phenomenon has been seen already in those using naltrexone for alcohol dependence.