Can Strattera Reduce Binge Eating?
While Strattera is primarily used to treat attention deficit hyperactivity disorder (ADHD), it may also be used off-label to help manage symptoms of binge eating in eating disorders. However, consulting a healthcare professional before starting any new medication regimen is essential.
What is Strattera?
Strattera, also known by its generic name atomoxetine, is a prescription medication primarily used to treat attention deficit hyperactivity disorder (ADHD) in adults and some children. It is classified as a selective norepinephrine reuptake inhibitor (SNRI), changing how your brain absorbs the chemical norepinephrine. This can be useful in your prefrontal cortex, where it can help suppress impulsivity by increasing inhibition [1].
Strattera is an oral capsule that is usually taken daily. Its mechanism of action is similar to that of the antidepressant bupropion, which is also known by the brand name Wellbutrin.
Strattera is just as effective as stimulant medications such as Adderall, yet it is not a stimulant. It is not addictive and, therefore, a valuable option for patients at risk of substance abuse or children with tics or anxiety [2, 3]. Strattera is also less likely to have side effects of insomnia, although some sleep difficulties have been reported [1].
In addition to treating ADHD, Strattera can help decrease hyperactivity, improve attention span, and reduce impulsive behaviours. However, it can cause side effects that can be disruptive for the individual. These include nausea, headaches, appetite loss and insomnia, which can range from mild to severe, including nausea and appetite loss [1].
What is Binge Eating?
Binge eating is defined as eating a large amount of food in a short period. Critically, a feeling of loss of control sets binge eating apart from overeating or eating from hunger [4, 5, 6]. It is a central symptom of Binge Eating Disorder (BED), a type of eating disorder first described in 1992 and formally recognised in the DSM-5 in 2013 [7].
Binge eating is associated with poor physical, behavioural, and psychosocial health [4]. It is likely to cause obesity, cardiovascular difficulty, mobility issues, as well as mental health symptoms [8]. It can also occur in related eating disorders, including anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified.
Neurobiology of Binge Eating
The neurobiology of binge eating is distinct from the neurobiology and psychological traits of obese individuals. This highlights the fact that binge eating is a severe mental health disorder that needs to be more recognised.
Individuals who binge have higher impulsivity and compulsivity traits. This means that they find it more challenging to regulate their behaviour (telling themself not to binge) and resist impulses (the binge urges). These features are similar to OCD and ADHD, which are characterised by compulsions and impulsivity, respectively. The neurotransmitters involved may include dopamine, opioids and serotonin, which will be helpful when looking for treatments for binge eating [9].
Prevalence of Binge Eating
The prevalence of BED is estimated to be 1-3% in the general population, but it is much higher in help-seeking obese subjects [7]. In a study involving 1,785 subjects drawn from 18 weight control programs, approximately 29% met the criteria for BED [10].
Can Strattera Treat Binge Eating?
The ADHD drug Strattera, also known as atomoxetine, was shown to reduce binge frequency in BED [11]. This is because Strattera may reduce appetite and improve impulse control, making it easier for people with BED to overcome their urges, maintain a balanced diet and even achieve weight loss. Only three out of the 40 patients involved in the study chose to discontinue atomoxetine due to its side effects. These were common side effects of psychoactive drugs, involving increased feelings of depression, constipation and nausea.
One further study has looked at the connection between binge eating and Strattera. This was a case report of a patient with anorexia, a binge-purge subtype, whose binge urges subsided after 4 months of atomoxetine [12]. When interpreting this result, it is critical to remember that this was a case study on a patient group different to the general population or people with only binge eating problems.
As only one more extensive study supports the use of Strattera in binge eating, it is not recommended that you take Strattera to stop binge eating. It is best to consult a healthcare provider who can select the best treatment.
Treatment of Binge Eating Disorder
BED has been effectively treated by multiple other types of medications, including antidepressants, anti-obesity agents, and anticonvulsants [13].
For instance, the pro-drug of lisdexamfetamine, a stimulant similar to Adderall, is the only drug approved by the FDA for the treatment of BED in adults [14]. Other medications like topiramate and sibutramine have also been shown to significantly reduce binge eating behaviour and body weight in BED, mainly when BED occurs in obese individuals [15, 16]. Treatments for binge eating in bulimia nervosa include antidepressants and cognitive behavioural therapy (CBT).
Summary: Strattera and Binge Eating
To summarise, the available evidence supports the efficacy of Strattera in reducing binge eating. However, the evidence is limited, so Strattera is not an FDA-approved treatment for binge eating. Therefore, it is difficult and not advised to obtain and take Strattera unless you have been prescribed the drug by healthcare professionals for treating ADHD symptoms.