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Takgbajouah M, Buscemi J. Applying the developmental model of use disorders to hedonic hunger: a narrative review. J Addict Dis 2021; 40:47-55. [PMID: 34002675 DOI: 10.1080/10550887.2021.1926881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Hedonic hunger (HH) occurs when individuals are driven to consume highly palatable food for pleasure, rather than to satisfy a caloric need. Currently, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) does not recognize HH as a use disorder. Previous research has noted physiological, neurobiological, and treatment similarities between HH, binge eating behavior and substance use, leading to the speculation of the existence of food addiction (FA). The purpose of the current review was to explore the literature on the developmental similarities between substance use, HH, binge eating behavior, and other use disorders to provide more evidence for the recognition of FA as an official use disorder, to add to the evidence in favor of a developmental model of use disorders, and to inform the development of interventions that target modifiable symptoms associated with use disorders. METHODS We provide a narrative review of the literature on developmental factors associated with both HH and substance use. RESULTS & DISCUSSION Adverse childhood experiences and attachment have been previously linked to both substance use and maladaptive eating behaviors. Adverse childhood experiences are linked with insecure attachment and emotion dysregulation, which is linked with compulsive behaviors and substance use. Clinical and research implications are discussed in terms of a developmental model of use disorders and the formal recognition of FA in the next edition of the DSM.
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Appolinario JC, Nardi AE, McElroy SL. Investigational drugs for the treatment of binge eating disorder (BED): an update. Expert Opin Investig Drugs 2019; 28:1081-1094. [PMID: 31714807 DOI: 10.1080/13543784.2019.1692813] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction: Binge eating disorder (BED) is the most common eating disorder and is frequently associated with psychiatric and medical comorbidities and functional impairment. Although psychological treatments have been the cornerstones of BED treatment, pharmacologic interventions also play an important part of the multimodal management of this condition.Areas covered: This review examines investigational, approved and other pharmacological agents for the treatment of BED. We searched PubMed and clinicaltrials.gov to identify pharmacological interventions for the management of this condition.Expert opinion: BED pharmacological studies have incorporated new drug targets based on our enhanced understanding of the pathophysiology of BED. Neurobiological dysregulation in the reward center and impulse control circuitry and related disturbances in dopamine neurotransmission are among the neurobiological explanations that have been suggested for BED. These mechanisms serve as a pharmacodynamic foundation for the development of new compounds such as lisdexamfetamine (LDX) and dasotraline. Despite these advances, pharmacological trials in BED have numerous challenges that must be overcome. For most compounds studied, larger and more definitive trials is a high priority.
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Affiliation(s)
- Jose C Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Antonio E Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Susan L McElroy
- Department of Psychiatry and Behavioral Neuroscience, Lindner Center of HOPE, Mason, OH, USA and University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Abstract
Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, and binge-eating disorder, constitute a class of common and deadly psychiatric disorders. While numerous studies in humans highlight the important role of neurobiological alterations in the development of ED-related behaviors, the precise neural substrate that mediates this risk is unknown. Historically, pharmacological interventions have played a limited role in the treatment of eating disorders, typically providing symptomatic relief of comorbid psychiatric issues, like depression and anxiety, in support of the standard nutritional and psychological treatments. To date there are no Food and Drug Administration-approved medications or procedures for anorexia nervosa, and only one Food and Drug Administration-approved medication each for bulimia nervosa (fluoxetine) and binge-eating disorder (lisdexamfetamine). While there is little primary interest in drug development for eating disorders, postmarket monitoring of medications and procedures approved for other indications has identified several novel treatment options for patients with eating disorders. In this review, I utilize searches of the PubMed and ClinicalTrials.gov databases to highlight emerging treatments in eating disorders.
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Affiliation(s)
- Michael Lutter
- Eating Recovery Center of Dallas, 4716 Alliance Blvd. #400, Plano, TX, 75093, USA.
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Gaekens T, Guillaume M, Borghys H, De Zwart LL, de Vries R, Embrechts RCA, Vermeulen A, Megens AAHP, Leysen JE, Herdewijn P, Annaert PP, Atack JR. Lipophilic nalmefene prodrugs to achieve a one-month sustained release. J Control Release 2016; 232:196-202. [PMID: 27107723 DOI: 10.1016/j.jconrel.2016.04.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 04/18/2016] [Accepted: 04/18/2016] [Indexed: 11/18/2022]
Abstract
Nalmefene is an opioid antagonist which as a once-a-day tablet formulation has recently been approved for reducing ethanol intake in alcoholic subjects. In order to address the compliance issue in this patient population, a number of potential nalmefene prodrugs were synthesized with the aim of providing a formulation that could provide plasma drug concentrations in the region of 0.5-1.0ng/mL for a one-month period when dosed intramuscular to dogs or minipigs. In an initial series of studies, three different lipophilic nalmefene derivatives were evaluated: the palmitate (C16), the octadecyl glutarate diester (C18-C5) and the decyl carbamate (CB10). They were administered intramuscularly to dogs in a sesame oil solution at a dose of 1mg-eq. nalmefene/kg. The decyl carbamate was released relatively quickly from the oil depot and its carbamate bond was too stable to be used as a prodrug. The other two derivatives delivered a fairly constant level of 0.2-0.3ng nalmefene/mL plasma for one month and since there was no significant difference between these two, the less complex palmitate monoester was chosen to demonstrate that dog plasma nalmefene concentrations were dose-dependent at 1, 5 and 20mg-eq. nalmefene/kg. In a second set of experiments, the effect of the chain length of the fatty acid monoester promoieties was examined. The increasingly lipophilic octanoate (C8), decanoate (C10) and dodecanoate (C12) derivatives were evaluated in dogs and in minipigs, at a dose of 5mg-eq. nalmefene/kg and plasma nalmefene concentrations were measured over a four-week period. The pharmacokinetic profiles were very similar in both species with Cmax decreasing and Tmax increasing with increasing fatty acid chain length and the target plasma concentrations (0.5-1.0ng/mL over a month-long period) were achieved with the dodecanoate (C12) prodrug. These data therefore demonstrate that sustained plasma nalmefene concentrations can be achieved in both dog and minipig using nalmefene prodrugs and that the pharmacokinetic profile of nalmefene can be tuned by varying the length of the alkyl group.
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Affiliation(s)
- Tim Gaekens
- API Small Molecule Development, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Michel Guillaume
- API Small Molecule Development, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Herman Borghys
- Neuroscience, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Loeckie L De Zwart
- Drug Metabolism and Pharmacokinetics, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Ronald de Vries
- Drug Metabolism and Pharmacokinetics, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Roger C A Embrechts
- Drug Product Development, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - An Vermeulen
- Clinical Pharmacology, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Anton A H P Megens
- Neuroscience, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Josée E Leysen
- Neuroscience, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium; Department of Nuclear Medicine and PET Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Piet Herdewijn
- Laboratory of Medicinal Chemistry, Rega Institute for Medical Research, Katholieke Universiteit Leuven, Minderbroedersstraat 10, Box 1030, B-3000 Leuven, Belgium
| | - Pieter P Annaert
- Laboratory for Pharmacotechnology and Biopharmacy, Katholieke Universiteit Leuven, O&N2, Herestraat 49-Box 921, B-3000 Leuven, Belgium
| | - John R Atack
- Neuroscience, Janssen Pharmaceuticals, Turnhoutseweg 30, B-2340 Beerse, Belgium.
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