Methylphenidate treatment for binge-eating disorder in a 12-year-old boy

Binge-eating disorder (BED) is defined as frequent episodes of binge eating, and the subjective feeling of loss of control over food intake, in the absence of inappropriate compensatory behaviours. Although it is one of the most common eating disorders in adults, it is less common in childhood and adolescence, and literature about its diagnosis and treatment in children and adolescents is limited. Here, we report a 12-year-old boy, with BED, who had not responded to conventional therapies, and showed recovery with methylphenidate therapy. He had lost his mother a year ago, and had depression symptoms since then, and binge-eating episodes for the last 3 months. His depression symptoms were ameliorated in a month with fluoxetine 20 mg, but his binge-eating episodes continued with the same frequency and severity, despite the drug and cognitive behavioural therapy. Twice daily short-acting methylphenidate (Ritalin 10 mg.) was added then, and with ritalin, his bingeeating episodes were dramatically decreased in frequency. Over the years, various strategies and guidelines for treatment have been proposed for BED, especially in adults, including pharmacological and psychotherapeutic strategies. Stimulants were also used for BED. Lisamfetamine has been shown to reduce the frequency of exacerbations in adults with binge-eating disorders. There are case reports about methylphenidate use for bulumia nervosa (but not for BED) in adults, but to our knowledge, to date, there is not a case reported methylphenidate use for BED in children and adolescents in the literature. In conclusion, data from these reports suggest a possible benefit of using psychostimulants in the treatment of children respond poorly to conventional therapies. Clinical trials are needed to fully evaluate the efficacy and tolerability of psychostimulants in this respect.