Growing evidence suggests that
antiepileptic drugs (AEDs) may be useful in managing some
eating disorders. In the present paper, we provide a brief overview of
eating disorders, the rationale for using AEDs in the treatment of these disorders and review the data supporting the effectiveness of specific AEDs in the treatment of patients with
eating disorders. In addition, the potential mechanisms of action of AEDs in these conditions are discussed. Of the available AEDs,
topiramate appears to have the broadest spectrum of action as an anti-
binge eating, anti-purging and
weight loss agent, as demonstrated in two placebo-controlled studies in
bulimia nervosa and three placebo-controlled studies in
binge-eating disorder (BED) with
obesity.
Topiramate may also have beneficial effects in
night-eating syndrome and sleep-related
eating disorder, but controlled trials in these conditions are needed. The results of one small controlled study suggest that
zonisamide may have efficacy in BED with
obesity. However, both
topiramate and
zonisamide are associated with adverse effect profiles that may limit their use in patients with
eating disorders.
Phenytoin may be effective in some patients with compulsive
binge eating, particularly if co-morbid EEG abnormalities are present, but available data are too varied to allow definitive conclusions to be made.
Carbamazepine and
valproate may be effective in treating patients with
bulimia nervosa or
anorexia nervosa when they are used to treat an associated psychiatric (e.g. mood) or neurological (e.g.
seizure) disorder; otherwise, both agents, particularly
valproate, are associated with
weight gain. In conclusion, AEDs have an emerging role in the management of some
eating disorders.