Escitalopram, also known as Cipralex or Lexapro, is a medication used to treat depression, anxiety, panic attacks, and obsessive-compulsive disorder (OCD). It belongs to a class of medications called selective serotonin reuptake inhibitors (SSRI). Escitalopram works by increasing levels of serotonin in the brain, which is an important chemical messenger that balances mood. In recent years, research has also shown that escitalopram can help people with binge eating disorder.
What is binge eating disorder?
Binge eating disorder is a serious mental health condition where a person has recurrent episodes when they eat excessively and uncontrollably. Binge eating is different from overeating. Almost everyone will overeat from time to time. Binge eating, on the other hand, is a lot less common and causes a lot of psychological distress for people suffering from it.
When binge eating, you may find you eat very large amounts of food in a short period of time, often to the point of feeling uncomfortably full. You may be eating even when you aren’t hungry. You may feel embarrassed about your eating, and feel you need to hide or eat alone. Binge eating disorder can lead to a number of physical and emotional health problems, such as unhealthy weight, high blood pressure, and depression.
The exact cause of binge eating disorder is not fully understood, but it is thought to be related to a variety of biological, psychological, and environmental factors. Some research suggests that imbalances in brain chemicals, such as serotonin, may play a role. This is where escitalopram comes in.
How does escitalopram help with binge eating disorder?
Escitalopram works by increasing levels of serotonin in the brain. Serotonin is a neurotransmitter that is involved in a number of important functions, including mood, anxiety, and appetite. By increasing serotonin levels, escitalopram may help to improve mood and reduce anxiety, which can in turn help to reduce the frequency and severity of binge eating episodes.
Does escitalopram work for binge eating disorder?
Escitalopram is not officially approved by Health Canada for treating binge eating disorder. Compared to other SSRI medications, escitalopram is less well studied for treating this condition than other medications in this class. However, in one 12-week study, escitalopram did help people with binge eating disorder reduce their weight and decrease the severity of their symptoms, for example by lessening how often they binge ate.
Ultimately, the best way to treat binge eating – whether with medication or not, and if so, which one – is a highly individual decision you have to make with your doctor’s help. You must take into account the underlying factors for why you binge eat, your overall health, your other medications, and how well you react to different medications.
What side effects does escitalopram have?
Like all medications, escitalopram can cause side effects.
In the first few weeks of starting escitalopram, you may have:
- Nausea or upset stomach
- A dry mouth
- Headaches
- Trouble sleeping or feeling drowsy
- Diarrhea
- Sweating
Taking escitalopram with food can help with nausea. If it is affecting your sleep, take escitalopram either early in the morning or before bedtime, depending on how it affects you.
In the long run, escitalopram can cause:
- Decreased libido (less interest in sex)
- Difficulty having an orgasm
- Difficulty with ejaculation
Rarely, SSRI medications like escitalopram can increase the risk of suicide. At any time, if you feel like you are thinking about hurting yourself or someone else, get medical help right away.
Some side effects are temporary and get better on their own with time. Other side effects may mean escitalopram is not the best option for you. How do you tell the difference? The best way is by working together with your healthcare provider.
If you experience any bothersome symptoms while taking escitalopram, start by getting in touch with your pharmacist or doctor. It’s important not to abruptly stop taking escitalopram on your own. This can cause uncomfortable discontinuation symptoms, like anxiety, insomnia, imbalance, and feeling like you have the flu.
In summary, escitalopram can help decrease the severity of binge eating disorder based on the results of one clinical study. In this same trial, patients also saw a reduction in their weight from taking escitalopram compared to placebo. Escitalopram can cause some side effects like nausea, sleepiness or difficulty falling asleep, decreased libido, and difficulty with orgasm. To make the most informed decision about whether using escitalopram will help you with binge eating disorder, talk to your healthcare provider to see how the information in this article applies in your specific situation.
1McElroy SL, Guerdjikova AI, Mori N, O'Melia AM. Pharmacological management of binge eating disorder: current and emerging treatment options. Ther Clin Risk Manag. 2012;8:219-41. doi: 10.2147/TCRM.S25574. Epub 2012 May 8. PMID: 22654518; PMCID: PMC3363296.
2Duan H, Zhu L, Li M, Zhang X, Zhang B, Fang S. Comparative efficacy and acceptability of selective serotonin reuptake inhibitor antidepressants for binge eating disorder: A network meta-analysis. Front Pharmacol. 2022 Sep 6;13:949823. doi: 10.3389/fphar.2022.949823. PMID: 36147335; PMCID: PMC9486087.
3Guerdjikova AI, McElroy SL, Kotwal R, et al. High-dose escitalopram in the treatment of binge-eating disorder with obesity: a placebo-controlled monotherapy trial. Hum Psychopharmacol. 2008;23(1):1–11.
