Antidepressant medicines may reduce episodes of binge eating in those
who have
binge eating disorder, and they may help with related
depression or
anxiety.
It may take several weeks for antidepressants to relieve symptoms
associated with binge eating disorder, although they may become effective
sooner. You may need to continue taking antidepressants over a long period of
time to prevent a
relapse.1
Antidepressants that may be used to treat binge eating disorder
include:2, 3
- Selective serotonin reuptake inhibitors (SSRIs)
such as fluoxetine (Prozac, for example) or fluvoxamine (Luvox).
-
Tricyclics, such as imipramine (Impril, Tofranil) or desipramine.
- Atypical antidepressants such as bupropion (Wellbutrin, for
example) or trazodone (Desyrel).
Antidepressants regulate brain chemicals that control mood. They can
help reduce the compulsive behaviour that leads to binging. These drugs can
also help people who have both depression and binge eating disorder.
Antidepressants may produce some bothersome, but often temporary,
side effects depending on the type of antidepressant.
Selective serotonin reuptake inhibitors (SSRIs)
These medicines help reduce binging and may also help people who
are obese to lose weight.4
Studies show that SSRIs may be less bothersome than other
antidepressants, such as tricyclics. SSRIs have less serious side effects and
are less dangerous in case of an overdose. Although side effects of SSRIs are
usually mild, they can include nausea, loss of appetite, diarrhea, anxiety,
irritability, problems sleeping or drowsiness, loss of sexual desire or
ability, headaches, dizziness, and dry mouth. After several weeks of treatment,
SSRI side effects may be less or may go away completely.
Be sure to tell your doctor about all the medicines and herbal
preparations you are currently taking.
Tricyclic antidepressants
Tricyclic side effects can include stomach upset, constipation, dry
mouth, blurred vision, and drowsiness. Some people gain weight and have
problems with sexual desire and ability. Tricyclics are started in low doses
and gradually increased to avoid overdose and other serious side effects.
Be sure to tell your doctor about all the medicines and herbal
preparations you are currently taking. Tricyclic antidepressants can have
serious interactions with other medicines, including those used to treat
seizures, such as phenytoin (Dilantin, for example), or certain heart
medicines, such as digoxin (for example, Lanoxin).
Atypical antidepressants
Bupropion and trazodone have different side effects than tricyclic
antidepressants. They have side effects similar to those of SSRIs and may have
additional side effects.
Possible side effects of bupropion include weight loss, agitation,
confusion, nervousness, and anxiety. In rare cases, bupropion can cause other
serious side effects, such as allergic reactions, heart palpitations, and
seizures.
Possible side effects of trazodone include drowsiness, dizziness or
light-headedness, blurred vision, weight gain, dry mouth, constipation,
headache, and nausea.
What to think about
You may start to feel better within 1 to 3 weeks of taking
antidepressant medicine. But it can take as many as 6 to 8 weeks to see more
improvement. If you have questions or concerns about your medicines, or if you
do not notice any improvement by 3 weeks, talk to your doctor.
Tell your doctor about every medicine or supplement (prescription
or over-the-counter) you are taking before starting an antidepressant. Some
antidepressants can have serious interactions with other medicines or dietary
supplements.
Advisories. Health Canada and the U.S. Food
and Drug Administration (FDA) have issued
advisories to patients, families, and health
professionals to closely monitor children and adults taking antidepressants for
warning signs of suicide. This is especially important
at the beginning of treatment or when doses are changed.