Current drug treatment of patients with bulimia nervosa and binge-eating disorder: selective serotonin reuptake inhibitors versus mood stabilizers.

Our aim was to review and compare findings from controlled trials and previous reviews concerning current drug treatment of patients suffering from bulimia nervosa (BN) and binge eating disorder (BED). Thus we selected published articles quoted over the last 10 years in the databases of Medline and Cochrane Library. The combination of pharmacological and psychological treatments is superior to the single psychotherapeutic approach, which in turn is superior to single drug treatment (just superior to placebo). Among drug treatments, SSRIs are the first line choice treatments, especially in primary care. They are more acceptable and tolerated by patients, moreover effective even if investigations on long-term outcomes are lacking. A number of patients, however, do not respond to these drugs. For them it is necessary to find new therapeutic strategies. Mood stabilizers are promising in this regard. In particular, topiramate seems to allow reduction of binge eating and weight in SSRI non-responder patients.