Evaluating the use of lamotrigine to reduce mood lability and impulsive behaviors in adults with chronic and severe eating disorders

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity - Tập 27 Số 5 - Trang 1775-1785 - 2022
Erin E. Reilly1,2,3, Laura A. Berner4,2, Mary Ellen Trunko2, Terry Ann Schwartz2, Leslie K. Anderson2, Angeline Krueger2, Xinze Yu2, Joanna Y. Chen2,5, Anne Cusack2, Tiffany Nakamura2, Walter H. Kaye2
1Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
2Department of Psychiatry, UCSD Health Eating Disorders Center for Research and Treatment, University of California, San Diego, San Diego, USA
3Department of Psychology, Hofstra University, Hempstead, USA
4Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
5Department of Psychology, Drexel University, Philadelphia, USA

Tóm tắt

Abstract Background Gold-standard psychological and pharmacological treatments for bulimic-spectrum eating disorders only result in remission for around 50% of patients; patients with affective lability and impulsivity represent a subgroup with particularly poor outcomes. Both dialectical behavior therapy (DBT), a treatment for emotion dysregulation, and lamotrigine, a mood stabilizer, have demonstrated promise for targeting affective lability and impulsivity; however, data exploring the combination of these interventions remain limited. Objective We followed a group of women with recurrent dysregulated eating behaviors (N = 62) throughout intensive DBT treatment and compared the symptom trajectory of those prescribed lamotrigine (n = 28) and those who were not (n = 34). Method Participants completed surveys every 2 weeks throughout treatment. Results Group analyses suggested that all participants self-reported decreases in emotional reactivity, negative urgency, and symptoms of borderline personality disorder (BPD). The lamotrigine group reported greater elevations in BPD symptoms at baseline, but demonstrated steeper decreases in emotion and behavioral dysregulation than the non-matched comparison group. Within-subject analyses suggested that within the lamotrigine group, subjects reported greater decreases in symptoms following prescription of lamotrigine. Conclusions Findings provide initial data suggesting that lamotrigine could be useful as an adjunctive treatment for patients with affective lability and impulsivity. Level of evidence IV, time series without randomization.

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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity

Tập 27 Số 5

1775-1785

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