Pharmacological interventions for binge eating: lessons from animal models, current treatments, and future directions.

Binge eating behavior has been noted in some eating disorders as well as in obesity. The goal of this paper is to review current, non-serotonergic pharmaceutical approaches to treat binge eating. Further, using information derived from preclinical models, we discuss candidate neurotransmitter systems for study as targets for the treatment of binge eating. Dopaminergic circuits have been implicated in both laboratory animal models and human studies of binge eating, though existing medications specifically targeting the dopaminergic system have been found to have adverse side effects. Opioidergic and gamma-aminobutyric acid (GABA) systems also appear to be highly involved in aspects of binge eating; further, opioid antagonists, such as naloxone and naltrexone, and GABA agonists, such as baclofen, have all been shown to be effective in treating alcohol dependence and may be equally efficacious in attenuating binge eating. Preclinical evidence, and some clinical evidence, suggests that cannabinoid antagonism may also be useful in the treatment of binge eating, although the specific effect of antagonists, on binge consumption remains unclear. Overall, each of these neurotransmitter systems provides a promising avenue for new pharmacotherapy development for binge eating, and preclinical and human studies provide a strong rationale for the development of highly-selective drugs that target this neurocircuitry.