Combination Phentermine-Topiramate Extended Release for the Treatment of Binge Eating Disorder: An Open-Label, Prospective Study

Abstract

Objective: The goal of this study was to obtain preliminary data on the usefulness of the combination of phentermine and topiramate extended release (phentermine-topiramate) in binge-eating disorder (BED) associated with obesity or overweight. Design: Ten participants with BED and obesity or overweightness with at least one weight-related complication received phentermine-topiramate in an open-label, prospective, 12-week trial. The primary outcome measure was change in weight. The study was registered under the identifier NCT02659475 at ClinicalTrials.gov. Results: Seven participants completed the study. Phentermine-topiramate treatment was associated with significant reductions in weight, body mass index, binge-eating episode frequency, and measures of global clinical severity, eating disorder psychopathology, and obsessive-compulsive symptoms. Mean daily dose of phentermine-topiramate at endpoint was 6.8 to 41.4mg per day. The most common adverse event (AE) was dysgeusia. There were no serious AEs, and no participants displayed symptoms of medication misuse or withdrawal. Conclusion: Phentermine-topiramate could be helpful for weight loss and reduction of binge-eating symptoms in patients with obesity or overweight in addition to BED. Controlled studies are warranted.

Keywords: Qsymia®; binge eating; obesity; phentermine-topiramate; weight loss.

Conflict of interest statement

FUNDING:Funding for this study was provided by Lindner Center of HOPE (LCOH). DISCLOSURES:Vivus Inc. provided the phentermine–topiramate medication for this study. Vivus Inc. had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Dr.Guerdjikova is employed by the University of Cincinnati College of Medicine and is a consultant for Bracket. Mrs. Mori is employed by the University of Cincinnati College of Medicine and is a consultant for Bracket. Mr. Blom and Mrs.Williams have no conflicts of interest relevant to the content of this article. Dr. McElroy is a consultant to and/or member of the scientific advisory boards of Bracket, F. Hoffmann-La Roche Ltd., MedAvante, Myriad, Naurex, Novo Nordisk, Shire, and Sunovion; is a principal or co-investigator on studies sponsored by the Alkermes, Forest, Marriott Foundation, National Institute of Mental Health, Naurex, Orexigen Therapeutics, Inc., Shire, Sunovion, and Takeda Pharmaceutical Company Ltd.; and is an inventor on United States Patent No. 6,323,236 B2, “Use of Sulfamate Derivatives for Treating Impulse Control Disorders,” and along, with the patent’s assignee, University of Cincinnati, Cincinnati, Ohio, has received payments from Johnson & Johnson, which has exclusive rights under the patent.

Figures

FIGURE 1.

Cumulative mean weight (kg) change and weekly binge episodes over 12 weeks of phentermine-topiramate treatment