Citalopram in the Treatment of Binge-Eating Disorder: A Placebo-Controlled Trial
J Clin Psychiatry 2003;64(7):807-813
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: 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
Method: 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.
Results: 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).
Conclusion: 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