Binge-eating Disorder
Conditions
Keywords
Binge, Binge-eating disorder, Oxytocin, Over-eating, Impulse Control
Brief summary
This study evaluates the impact of intranasal oxytocin vs placebo in patients with binge eating disorder or episodes of binging. We hypothesize that 8 weeks of intranasal oxytocin vs placebo will improve clinical outcomes \[reduction in bingeing frequency\], and have a satisfactory safety and tolerability profile. We will also explore the predictive value of changes in homeostatic appetite, reward sensitivity, and impulse control, the identified underlying mediators, as assessed 4 weeks into the intervention, for treatment success after 8 weeks of the intervention.
Detailed description
Study staff will screen patients for eligibility as per eligibility criteria. At least 60 eligible patients will be randomized 1:1 (active oxytocin: placebo) by an unblinded pharmacist. All other study staff and test subjects will be blinded. Study subject medical histories, physical exams, anthropometric measurements, labs, EKG's, and eating habits will be monitored over 8 weeks. Subjects will be evaluated at the following intervals: Baseline, week 2, week 4, week 8, and week 16 (8 weeks post-treatment).
Interventions
oxytocin nasal spray
Nasal solution without oxytocin
Sponsors
Study design
Masking description
Study staff and patients are blinded. The pharmacist is unblinded.
Eligibility
Inclusion criteria
* Males and females, 18-70 years old * BMI greater than or equal to 18.5 * BED as assessed by Structured Clinical Interview for DSM-5 Disorders (SCID-5-RV) OR Other Specified Feeding or Eating Disorder (OSFED) - Binge-eating disorder (of low frequency and/or limited duration) (SCID-5-RV) OR Bulimia Nervosa (BN) through excessive exercise and/or fasting to avoid gaining weight after episodes of binge eating. For individuals with OSFED-BED, the frequency of subjective and objective binge eating episodes will meet the frequency (Criterion D) for BED.
Exclusion criteria
* Substance use disorder active within the last 6 months, or clinical suspicion of ongoing substance use disorder at the discretion of the study clinician at the time of screening based on history and/or laboratory results * Medication changes that have not reached steady state concentration, measured by the equivalent of 5 half-lives of that medication * Use of medications for binge eating disorder or weight loss unless at a stable dose for at least 12 weeks * History of any of the following medical conditions: inflammatory bowel disease or untreated thyroid disease * Uncontrolled epilepsy (as defined by a seizure within the last 12 months) * Clinically relevant ventricular arrhythmias, coronary heart disease, known long QTc, and hypertrophic cardiomyopathy * Hematocrit \>2% below normal * Hemoglobin A1c \>8% * Use of insulin * ALT or AST \>2.5 times upper limit of normal * Glomerular filtration rate \< 60 mL/min * Hyponatremia. Note that, in order to be randomized, subjects must have Na ≥ 135 mEq/L. * Pregnancy or breastfeeding * Unwilling to use a medically acceptable form of contraception throughout the study period (female of child-bearing potential only) * History of psychosis or active suicidal ideation * Major depressive disorder likely to require initiation or change in active treatment * Borderline personality disorder as assessed by the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) * Current nicotine use, unless stable use for at least 12 weeks. * Participation in any clinical study involving an investigational drug, device, or biologic within 1 month of randomization * Any significant illness, condition, or medication that the Investigator determines could interfere with study participation and impact data collection or subject safety
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Binge Frequency | 8 weeks | Change in binge frequency as assessed by the Eating Disorder Examination clinical interview |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Reward sensitivity | 8 weeks | Predictive value of 4-week change in reward sensitivity per the Temporal Experience of Pleasure Scale (TEPS) Anticipatory Experience of Pleasure subscale score for 8-week change in binge episodes. Higher scores=greater anticipatory pleasuure/less anhedonia. Minimum/Maximum: 10-60 |
| Impulse control | 8 weeks | Predictive value of 4 week change in impulse control per Stop-Signal Reaction time in a Stop-Signal Task for 8 week change in binge frequency |
Countries
United States
Contacts
Massachusetts General Hospital