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Paired Medications Show Promise for Binge Eating Disorder Patients

New trials feature a phentermine-topiramate combination.

While drug development for AN and BN is quiescent, BED remains an active target for medication treatment development. Results fromarecent pilot drug trial suggest a new option for BED patients.

Combining phentermine and topiramate for obese BED patients

In a small study of 10 obese or seriously overweight patients,  Anna Guerdjikova, PhD, LISW, and colleagues at the Lindner Center of HOPE in Mason, OH, and the University of Cincinnati College of Medicine tested a combination of phentermine and topiramate in an open-label, prospective 12-week trial. The combination appeared to lead to loss of weight, and significant reductions in weight, body mass index, and importantly, frequency of binge-eating, global clinical severity, eating pathology, and obsessive-compulsive symptoms (Innov Clin Neurosci.2018; 15:17).

Seven out of 10 people completed treatment. The most common side effect reported in the study was dysgeusia, or disruption of the normal sense of taste. Notably, doses were lower than those used in monotherapy (7.5 mg phentermine and 46 mg of topiramate).The authors suggested that patients who cannot tolerate higher doses of topiramate alone might benefit from lower doses of topiramate combined with phentermine.   The authors stress that this was a short-term uncontrolled study and larger randomized, placebo-controlled trials will be needed.