Treatments of Night Eating Syndrome

When working with night eaters, one of the first things we asked our patients was to tell us what prescription medications and over-the-counter remedies they had tried to control their Night Eating Syndrome. Then, we made a list of all the things they’d tried, and went over it very carefully. Even though quite an array of medications had been taken, the striking finding was that almost nothing worked. A few medications helped some of the people some of the time, but nothing worked consistently. There was one exception, the medication combination called fen-phen.

Fen-Phen
You probably recall the publicity about the wonder drug combination of two medications, fenfluramine and phentermine, for the treatment of obesity in the early 1990s. This treatment had great success in helping people lose weight. Those of our patients who had tried this combination reported that their night eating disappeared while they were taking these medications. Unfortunately, it turned out that the long-term use of these drugs caused heart valve problems, and fen-phen was taken off the market.

The experience with fen-phen was important in helping us understand what may control night eating. This combination produced a very large increase in the neurotransmitter serotonin in the areas of the brain that deal with appetite. This knowledge helped direct attention to medications that might help in the treatment of Night Eating Syndrome, particularly those medications that affect serotonin.

Over-the-Counter Medications
Over-the-counter remedies have been widely used by night eaters, but they have shown very little benefit. Two of the most common treatments are the hormone melatonin and an herbal medication made from the kava kava root. Some patients reported that these two agents helped them fall asleep, but they didn’t stay asleep. In fact, they told us that they still woke up during the night and ate.

All of these reports were anecdotal, and we don’t know how many night eaters have tried these remedies. If you are going to try any over-the-counter medications or herbal preparations for any condition, be sure to consult your physician first. This is important, especially if you are taking other medications.

Selective Serotonin Reuptake Inhibitors
Unfortunately, medication, alone or in combination, has had little success either with weight loss or with Night Eating Syndrome. The effect of fen-phen was to increase the levels of the neurotransmitter serotonin in the brain areas controlling appetite. It seemed logical then that selective serotonin reuptake inhibitors (SSRIs) would have similar results. Under their personal physicians’ care, several patients tried various SSRIs. You may be familiar with some of their names, such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). These medications were originally designed for the treatment of depression.

Recently, however, they have been approved for other problems, such as anxiety disorders and eating disorders. Their efficacy in conditions other than depression and the experience with fen-phen suggested that we try the SSRI sertraline (Zoloft).

Related posts:

1. What Night Eating Syndrome Is Not?
2. Night Eating Syndrome and Sleep
3. Who Else Has Night Eating Syndrome?
4. Night Eating Syndrome – You Might Run across Other Night Eaters
5. Mood Disorders and Night Eating Syndrome
6. Night Eating Syndrome and Disturbed Sleep
7. Night Eating Syndrome and Polysomnography
8. Sleep Apnea and Night Eating Syndrome
9. Binge-Eating Disorder and Night Eating Syndrome
10. Night Eating Syndrome – Getting Help from Others