Nocturnal eating syndrome
A case report with therapeutic response to dexfenfluramine
Keywords:
Nocturnal eating syndrome, dexfenfluramine, serotonin, binge eating disorderAbstract
A woman with nocturnal eating syndrome responsive to dexfenfluramine (DXF) is reported. Eating consisted of nightly ingestion of large amounts of high-calorie meals and often sloppy meal consumption or preparation. Amnesia for the episodes was total. Anorexigenic medications produced partial control of her daytime carbohydrate craving and no nocturnal eating change. DXF stopped her eating behavior completely. Nocturnal eating herein meets all 4 DSM-III-R diagnostic criteria for binge eating disorder. 5-HT role in neural process controlling sleep-wakefulness (SW) has been widely shown. A 5-HT agonist like DXF could determine changes in the SW processes producing the therapeutic outcome reported herein. However, a specific DXF effect on the behavioral control of carbohydrate ingestion can not be dismissed.
Downloads
References
AMERICAN PSYCHIATRIC ASSOCIATION - Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. rev. Washington, DC: American Psychiatric Association, 1987.
BENSON,K.; FAULL, K. & ZARCONE, V. - Evidence for the role of serotonin in the regulation of slow wave sleep in schizophrenia. Sleep,14:133-139,1991.
BILLLIARD, M.- The Kleine-Levin syndrome. In: Kryger M., Roth T.& Dement W . Eds. Principles and Practice of Sleep Medicine. Philadelphia: WB Saunders: 377-378, 1989
DEVLIN,M.J. & WALSH, B.T. - Eating disorders and depression. Psychiatr Ann,19:473-476, 1989.
ICSD - International Classification of Sleep Disorders: Diagnostic and Coding Manual. Diagnostic Classification Steering Committee, Thorpy M.J., Chairman. Rochester. Minnesota: American Sleep Disorders Association,1990.
JOUVET, M.- Méchanismes des états de sommeil. In Benoit O., ed. Physiologie du Sommeil. Paris: Masson: 1-15, 1984.
ROPER, P.- Bulimia while sleepwalking, a rebuttal for the same automatism? Lancet:2 (8666):796 (letter) 1989.
SCHENCK, C.H.; HURTWITZ, T.D.; BUNDLIE, S.R. & MAHOWALD, M.W.- Sleep-related eating disorders: polysomnographic correlates of a heterogeneous syndrome distinct from daytime eating disorders. Sleep 14: 419-431, 1991.
STUNKARD, AJ; GRACE, W.J. & WOLFF, H.G.- The night-eating syndrome. A pattern of food intake among certain obese patients. Am J Med 19: 78-86, 1955.