Résumé
Le traitement médicamenteux des compulsions alimentaires chez le malade obèse est encore l’objet d’incertitudes. En effet, si quelques études contrôlées sont disponibles, elles n’ont inclus que trop peu de malades au total. Les antidépresseurs de type inhibiteurs de la recapture de la sérotonine, l’orlistat et les derniers anti-épileptiques ont fait la preuve de leur efficacité (niveau de preuve: bon), mais aussi de leurs effets secondaires, en particulier les anti-épileptiques. Ces médicaments ne sont efficaces en moyenne que chez un malade sur deux; ils n’agissent qu’après un délai d’au moins trois semaines et leurs effets persistent tant que dure leur prise. La dose efficace est en règle élevée. Leurs effets favorables sont d’autant plus importants et durent d’autant plus qu’un travail psychocomportemental a été effectué en parallèle.
Abstract
The effectiveness of pharmacological treatment of compulsive eating disorders in obese patients is as yet uncertain. Although some clinical trials have been carried out, not enough patients were involved in total. Antidepressants such as selective serotonin reuptake inhibitors, orlistat and the newest anti-epileptics have all been shown to be successful (proof level: good), but have also been seen to have side effects, particularly with respect to anti-epileptic drugs. On average, these drugs only work for one in two patients, they take at least three weeks to work and they only work for as long as they are being taken. They are generally only effective when taken in high doses. Their success is greater and more durable if used simultaneously with psycho-behavioral therapy.
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Rigaud, D. Médicaments contre les compulsions alimentaires. Obes 3, 42–46 (2008). https://doi.org/10.1007/s11690-008-0102-z
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DOI: https://doi.org/10.1007/s11690-008-0102-z