Naturalistic and Uncontrolled Pilot Study on the Efficacy of Vortioxetine in Binge Eating Disorder With Comorbid Depression

Abstract

Background: Binge eating disorder (BED) is clinically relevant by virtue of the global impairment, poor quality of life, and increased overall medical morbidity. The high comorbidity with psychiatric disorders, particularly depression, has received attention as a possible mediator of the poor outcome. Further, BED and depression share cognitive dysfunctions. This naturalistic and uncontrolled pilot study aimed at evaluating the efficacy of vortioxetine (VTX) on depressive symptoms in patients with BED, secondly the efficacy in improving a broad array of executive functions, and third to explore the effect on eating behavior and body weight.Methods: This pilot study involved 30 patients with BED and comorbid MDD, treated with VTX for 24 weeks. Assessments were run at baseline (t0), 4 (t1), 8 (t2), 12 (t3), and 24 (t4) weeks. Changes in depressive symptoms (HDRS and BDI), executive functions, eating behaviors (binge frequency and severity, night eating, food addiction), and body weight were estimated after treatment with VTX through GLM.Results: Significant improvements emerged after treatment with VTX in: depression (HDRS p < 0.001; BDI p = 0.002) regardless the dose of VTX and first diagnosis (BED/MDD), working memory (RAVLT acquisition p = 0.01, delay recall p < 0.001, RCFT percentage of recall p = 0.01, and Attentional Matrices p = 0.05), binge days frequency (p < 0.001), binge eating severity (BES p < 0.001), night eating (p = 0.001), food addiction (YFAS 2.0 p = 0.039), and body weight (p = 0.039). The improvement in depressive symptoms was associated with the concurrent improvement in night eating as assessed by the I-NEQ.Conclusions: VTX can be a valid therapeutic choice for patients with BED with comorbid depression in controlling the depressive symptoms, working memory, and eating behavior. Indeed, by acting on affective symptoms, neurocognitive functioning, and eating behaviors, it confirms the results already obtained with VTX in other disorders, expanding them to BED.

Development, validation and clinical use of the Eating Behaviors Assessment for Obesity (EBA-O)

“…The treatment is manifold and characterized by high dropout rates and poor long-term efficacy. Current therapeutic choices provide a multistep progression that includes dietary and behavioral changes, physical activity, drug treatment, up to bariatric surgery in selected cases [ 3 – 6 ]. However, although bariatric surgery seems to be the most effective treatment for obesity, some individuals do not respond adequately, especially in the long-term evaluation [ 7 ].…”

Executive functions and depressive symptoms interplay in binge eating disorder: A structural equation model analysis

“…These cognitive domains deserve further investigation, above all in the context of a recent meta‐analysis pointing out that more severe the clinical binge eating, the greater the likelihood to have impaired EF (Prunell‐Castañé et al., 2021). Still, some new evidence pointed out that novel treatment either active on depressive or cognitive symptoms may be efficacious on these domains as well as on binge eating severity in individuals with obesity and BED, but further replications on the long‐term are needed (Segura‐Garcia et al., 2021).…”

“…How to cite this article: Rania, M., Aloi, M., de Filippis, R., Carbone, E. A., Caroleo, M., De Fazio, P., & Segura-Garcia, C. (2021). Executive functions and depressive symptoms interplay in binge eating disorder: A structural equation model analysis.…”

“…The investigation of the association between binge eating severity and cognitive disabilities in light of depressive symptoms could enable to disentangle the independent effect of affective and cognitive domains on binge eating and fill the gap of previous evidence. Moreover, an integrated approach targeting either cognitive disabilities or depressive symptoms could potentially result in a more favourable outcome (Segura‐Garcia et al., 2021).…”

Network analysis of eating disorder and depression symptoms among university students in the late stage of COVID-19 pandemic in China

“…Low self-esteem and self-directedness are also linked to the development of EDs via depression ( 13 ). The “common-cause” model posits that cognitive inefficiency underlies both depression and EDs, leading to their comorbidity ( 14 ).…”