| Intervention and Comparator | Number of Studies (Sample Sizes) | Outcome and Results | Strength of Evidence |
|---|---|---|---|
| Second-generation antidepressants versus placebo | MA of 8 RCTs (N=416) | Antidepressants increased binge abstinence: RR, 1.67 (95% CI, 1.24 to 2.26, p=0.001) | High for benefit |
| MA of 7 RCTs (N=331) | Antidepressants decreased the frequency of binge episodes per week: mean difference, −0.67 (95% CI, −1.26 to −0.09, p=0.024) | High for benefit | |
| MA of 3 RCTs (N=122) | Antidepressants decreased the frequency of binge days: mean difference, −0.90 (95% CI, −1.48 to −0.32, p=0.002) | Moderate for benefit | |
| MA of 3 RCTs (N=122) | Antidepressants decreased eating-related obsessions and compulsions based on mean difference in YBOCS total, −3.84 (95% CI, −6.56 to −1.12, p=0.006); YBOCS obsessions, −1.53 (95% CI, −2.69 to −0.37, p=0.010); and YBOCS compulsions, −2.31 (95% CI, −3.85 to −0.76, p=0.003) | Moderate for benefit for total, obsessions, and compulsions | |
| MA of 4 RCTs (N=182) | No difference in weight: mean difference in kg, −3.91 (95% CI, −10.14 to 2.32, p=0.219) | Low for no difference | |
| MA of 6 RCTs (N=297) | No difference in BMI: mean difference, −1.05 (95% CI, −2.64 to 0.55; p=0.198) | Low for no difference | |
| MA of 3 RCTs (N=142) | Antidepressants decreased symptoms of depression: mean difference, −1.98 (95% CI, −3.67 to −0.28, p=0.022) | Low for benefit | |
| Topiramate versus placebo | 2 RCTs (N=468) | Topiramate increased binge abstinence | Moderate for benefit |
| 2 RCTs (N=468) | Topiramate decreased the frequency of binge episodes | Moderate for benefit | |
| 2 RCTs (N=468) | Topiramate decreased eating-related obsessions and compulsions | Moderate for benefit | |
| 2 RCTs (N=468) | Topiramate decreased weight | Moderate for benefit | |
| 1 RCT (N=407) | Topiramate improved general and eating-related psychological functioning indicated by increases in cognitive control of eating and decreases in symptoms of psychological distress, susceptibility to hunger, and disinhibition of control over eating | Low for benefit | |
| 1 RCT (N=407) | Topiramate decreased impulsivity | Low for benefit | |
| 1 RCT (N=407) | Topiramate decreased disability in family and social domains | Low for benefit | |
| Lisdexamfetamine versus placebo | MA of 3 RCTs (N=966) | Lisdexamfetamine increased binge abstinence: (RR, 2.61; 95% CI, 2.04 to 3.33; p=0.000) | High for benefit |
| 3 RCTs (N=966) | Lisdexamfetamine decreased binge episodes per week | High for benefit | |
| 3 RCTs (N=966) | Lisdexamfetamine decreased eating-related obsessions and compulsions based on mean difference in YBOCS total | High for benefit | |
| 3 RCTs (N=966) | Lisdexamfetamine decreased weight | High for benefit |
BMI = body mass index; CI = confidence interval; GI = gastrointestinal; MA = meta-analysis; N = number; RR = risk ratio; RCT = randomized controlled trial; SNS = sympathetic nervous system; YBOCS-BE = Yale-Brown Obsessions and Compulsions Scale modified for binge eating.
From: Discussion
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