Effectiveness of Antibiotic Treatment for Reducing Binge Eating and Improving Digestive Function in Bulimia Nervosa

Study Overview
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Brief Summary
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This study will determine the effectiveness of the antibiotic erythromycin in enhancing gastrointestinal function and decreasing the frequency of binge eating in people with bulimia nervosa.

Detailed Description
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Bulimia nervosa (BN) is a serious eating disorder that is characterized by frequent uncontrolled eating binges. These binges are often followed by compensatory behavior, including the following: self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications to induce purging; fasting; or excessive exercise. If left untreated, BN can lead to many serious health issues: tooth decay; irregular menstruation; bowel damage; constipation; heart and kidney disease; intestinal damage; puffiness, especially in the face and fingers; increased hair growth on the face and body; and mineral imbalances in the body. Although there is significant existing knowledge about the characteristics and treatment of BN, more information is needed about gastrointestinal (GI) function and its effect on binge eating behavior. This study will determine the effectiveness of the antibiotic erythromycin in enhancing GI function and decreasing the frequency of binge eating in people with BN. Participants in this 8-week, double-blind study will first undergo gastric emptying and GI hormone release testing for 1 day. Within 1 week of completing these pre-treatment tests, participants will be randomly assigned to receive either erythromycin or placebo for 6 weeks. Upon medication assignment, participants will meet with a psychiatrist to receive their assigned medication. Participants will receive medication at weekly study visits. Medication dosage will be increased if symptoms do not improve, or decreased if adverse medication side effects are reported. A final day of gastric emptying and GI hormone release testing, as well as routine blood tests, will take place in Week 7, after 6 weeks of medication treatment. Participants' weight will be measured at Weeks 1, 4, and 7. Participants will also receive an EKG 1 week after each upward dosage adjustment. Patients will be informed of their medication assignment at the Week 7 study visit, and will be referred to a non-study clinician for further treatment. For information on related studies, please see NCT00308776 and NCT00307190.

Official Title
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Effects of Erythromycin on Binge Eating and GI Function in Bulimia Nervosa

Conditions
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Bulimia Nervosa, Eating Disorders

Intervention / Treatment
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* Drug: Erythromycin
* Drug: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Meets criteria for bulimia nervosa Duration of illness is greater than 1 year Self-induces vomiting Weighs 80%-120 % of ideal weight Exclusion Criteria: Significant medical illness Current or lifetime history of schizophrenia, bipolar disorder, or other psychotic disorder, as defined by American Psychiatric Association criteria Moderate to severe depression, as defined by a score greater than 18 on the Hamilton Depression Scales Current diagnosis of organic mental disorder, factitious disorder, or malingering History of a personality disorder (e.g., schizotypal, borderline, or antisocial) that might interfere with assessment or compliance with the study procedures At risk for suicide Current psychotropic medications and current medications that affect GI function or that inhibit or induce cytochrome three A gene expression Currently pregnant, lactating, or planning to become pregnant Drug or alcohol abuse within the 3 months prior to study entry Abnormal EKG at baseline or 1 week following each upward dosage adjustment Anemia Known intolerance to erythromycin, or related antibiotics Abnormal results on liver function tests Electrolyte abnormalities

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Erythromycin<br>Subjects with Bulimia Nervosa will take erythromycin. | Drug: Erythromycin<br>* Erythromycin, 250 mg or 500 mg, three times a day for 6 weeks<br>* Other names: Ery-tab;|
| Placebo Comparator: Placebo<br>Participants will take matched placebo. | Drug: Placebo<br>* Placebo, 250 mg or 500 mg, three times a day for 6 weeks<br>* Other names: inactive substance;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Binge Frequency | Binge frequency was assessed by patient diary. All patients were asked to keep a diary of the number of daily binge eating and vomiting episodes which was collected at each weekly visit. | Measured at Week 7 | 
| Percent of Meal Remaining/Minute | percent of meal remaining/minute | Measured at Week 7 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Binge-Eating Disorder