Síndrome do comer noturno: como tratar?

Pinto, Thisciane Ferreira; Silva, Francisco Girleudo Coutinho da; Bruin, Veralice Meireles Sales de; Bruin, Pedro Felipe Carvalhedo de

doi:10.1590/1806-9282.62.07.701

Acessibilidade / Reportar erro

Brasil

Revista da Associação Médica Brasileira

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

REVIEW ARTICLES • Rev. Assoc. Med. Bras. 62 (7) • Out 2016 • https://doi.org/10.1590/1806-9282.62.07.701 copiar

Síndrome do comer noturno: como tratar?

Autoria SCIMAGO INSTITUTIONS RANKINGS

Resumo

A síndrome do comer noturno (SCN) caracteriza-se por ingestão calórica ≥ 25% do total diário após o jantar e/ou por dois ou mais despertares noturnos semanais acompanhados de alimentação. As causas da SCN não estão totalmente esclarecidas e parecem envolver uma dessincronização entre os ritmos circadianos de alimentação e sono, resultando em um atraso do padrão alimentar. Estimativas da prevalência de SCN na população geral estão em torno de 1,5% e, embora frequências bem mais elevadas tenham sido descritas em obesos, uma relação de causalidade entre SCN e obesidade não está claramente estabelecida. Desde os primeiros relatos da SCN, várias modalidades de tratamento têm sido propostas, embora, em muitos casos, a evidência ainda seja insuficiente e não exista um consenso sobre a abordagem ideal. Com o objetivo de realizar uma revisão crítica dos tratamentos propostos para a SCN, desde sua descrição original, foi realizada uma busca sistemática de artigos publicados nos periódicos indexados na base de dados MedLine / Pubmed entre 1955 e 2015. Dezessete artigos, abordando terapias não farmacológicas ou farmacológicas, preencheram os critérios de seleção. Com base nos artigos analisados, conclui-se que os agentes serotonérgicos e intervenções psicológicas, particularmente, a terapia cognitivo-comportamental, têm mostrado eficácia no tratamento da SCN. Uma combinação de terapias não farmacológicas e farmacológicas precisa ser considerada em estudos futuros sobre o tratamento desses pacientes.

Palavras-chave:
ritmo circadiano; obesidade; transtornos alimentares; transtornos do sono

	Study type	Treatment	Sample characteristics	Duration	Result
Friedman, 2002⁴²42 Friedman S, Even C, Dardennes R, Guelfi JD. Light therapy, obesity, and night-eating syndrome. Am J Psychiatry. 2002; 159(5):875-6.	Case report	Phototherapy 10,000 lux for 30 minutes	1 female aged 51 years with NES, obese	14 days	Improvement of depressive symptoms and nocturnal eating
Pawlow, 2003⁴⁴44 Pawlow L, O'Neil P, Malcolm R. Night eating syndrome: effects of brief relaxation training on stress, mood, hunger, and eating patterns. Int J Obes Relat Metab Disord. 2003; 27(8):970-8.	Controlled clinical trial	PMR	20 participants with NES (intervention, n=10; control, n= 10)	1 week	Reduction of nocturnal appetite and increased morning hunger
Friedman, 2004⁴³43 Friedman S, Even C, Dardennes R, Guelfi JD. Light therapy, nonseasonal depression, and night eating syndrome. Can J Psychiatry. 2004; 49(11):790.	Case report	Phototherapy 10,000 lux for 30 minutes	1 male aged 46 years with NES, not obese	14 days	Improvement of depressive symptoms and NES
Allison, 2010⁴⁶46 Allison KC, Lundgren JD, Moore RH, O'Reardon JP, Stunkard AJ. Cognitive behavior therapy for night eating syndrome: a pilot study. Am J Psychother. 2010; 64(1):91-106.	Non-controlled clinical trial	CBT	25 participants with NES (19 women)	12 weeks	Improvement of depressive symptoms and NES; weight loss
Vander Wal, 2015⁴⁷47 Vander Wal JS, Maraldo TM, Vercellone AC, Gagne DA. Education, progressive muscle relaxation therapy, and exercise for the treatment of night eating syndrome. A pilot study. Appetite. 2015; 89:136-44.	Controlled clinical trial	CBT, exercise, and education	44 patients with NES (education, n=14; CBT without exercise, n=15; CBT with exercise, n=14)	3 weeks	Improvement of NES using any of the three interventions

Author	Study type	Treatment	Sample characteristics	Duration	Result
Miyaoka, 2003³⁷37 Miyaoka T, Yasukawa R, Tsubouchi K, Miura S, Shimizu Y, Sukegawa T, et al. Successful treatment of nocturnal eating/drinking syndrome with selective serotonin reuptake inhibitors. Int Clin Psychopharmacol. 2003; 18(3):175-7.	Case series	Paroxetine (3 cases); fluvoxamine (1 case)	4 patients with NES	2 weeks	Effective control of episodes of nocturnal eating after 2-3 weeks of treatment
Winkelman, 2003³⁵35 Winkelman JW. Treatment of nocturnal eating syndrome and sleep-related eating disorder with topiramate. Sleep Med. 2003; 4(3):243-6.	Case series	Topiramate	2 patients with NES	N/I	Improved night eating, weight loss; the symptoms of NES returned one month after the end of treatment
Tucker, 2004³⁶36 Tucker P, Masters B, Nawar O. Topiramate in the treatment of comorbid night eating syndrome and PTSD: a case study. Eat Disord. 2004; 12(1):75-8.	Case report	Topiramate	1 female aged 40 years	9 months	Improvement of symptoms of NES, sleepiness; weight loss
O’Reardon, 2004³⁸38 O'Reardon JP, Stunkard AJ, Allison KC. Clinical trial of sertraline in the treatment of night eating syndrome. Int J Eat Disord. 2004; 35(1):16-26.	Open clinical trial	Sertraline	17 participants with NES (12 women)	12 weeks	Reduction in the number of awakenings; improvement in night eating
O’Reardon, 2006⁴⁸48 Halford JC, Boyland EJ, Lawton CL, Blundell JE, Harrold JA. Serotonergic anti-obesity agents: past experience and future prospects. Drugs. 2011; 71(17):2247-55.	Double-blind, randomized, placebo-controlled trial	Sertraline	34 participants with NES (sertraline, n=17; placebo, n=17)	8 weeks	Improvement in symptoms of NES and in quality of life; weight loss
Stunkard, 2006⁴⁹49 Crane JD, Palanivel R, Mottillo EP, Bujak AL, Wang H, Ford RJ, et al. Inhibiting peripheral serotonin synthesis reduces obesity and metabolic dysfunction by promoting brown adipose tissue thermogenesis. Nat Med. 2015; 21(2):166-72.	Open clinical trial	Sertraline	50 participants with NES	Not informed	Improvement in nocturnal hyperphagia, nocturnal awakenings with food intake, and depressive symptoms
Cooper-Kazaz, 2012⁵²52 Crow S. Treatment of binge eating disorder. Curr Treat Options Psychiatry. 2014; 1(4):307-14.	Case report	Topiramate	1 female aged 54 years with NES and depression	3 months	Improvement in symptoms of NES, sleep quality and self-esteem
Vander Wal, 2012⁵⁰50 Sebaaly JC, Cox S, Hughes CM, Kennedy MLH, Garris SS. Use of fluoxetine in anorexia nervosa before and after weight restoration. Ann Pharmacother. 2013; 47(9):1201-5.	Controlled randomized clinical trial	Escitalopram	40 participants with NES (escitalopram, n=20; placebo, n=20)	6 weeks	Improvement in symptoms of NES and weight loss did not differ between the groups
Allison, 2013⁵¹51 Flament MF, Bissada H, Spettigue W. Evidence-based pharmacotherapy of eating disorders. Int J Neuropsychopharmacol. 2012; 15(2):189-207.	Open clinical trial	Escitalopram	31 patients with NES (21 women)	12 weeks	Improvement in NES and depressive symptoms
Milano, 2013⁵⁵55 Vander Wal JS, Gang CH, Griffing GT, Gadde KM. Escitalopram for treatment of night eating syndrome: a 12-week, randomized, placebo-controlled trial. J Clin Psychopharmacol. 2012; 32(3):341-5.	Case series	Agomelatine	5 patients with NES (3 women)	10 weeks	Improvement in symptoms of NES and depression; weight loss
Milano, 2013⁵⁴54 Stunkard AJ, Allison KC, Lundgren JD, Martino NS, Heo M, Etemad B, et al. A paradigm for facilitating pharmacotherapy at a distance: sertraline treatment of the night eating syndrome. J Clin Psychiatry. 2006; 67(10):1568-72.	Case report	Agomelatine	1 female aged 39 years with NES and depression	3 months	Improvement in mood and symptoms of NES; weight loss

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] *Correspondence: Departamento de Medicina Clínica, Address: Rua Prof. Costa Mendes, 1608, 4º andar, Fortaleza, CE - Brazil, Postal code: 60430-140. pedrobruin@gmail.com