Bupropion plus Naltrexone for the Treatment of Binge-Eating Disorder: A Systematic Review and Meta-Analysis.

Objective: This meta-analysis aimed to evaluate the efficacy of these agents in BED patients.

Methods: We searched MEDLINE, Embase, and Cochrane databases up to February 2025 for randomized controlled trials (RCTs) comparing bupropion-naltrexone to placebo. The primary outcome was binge eating frequency. Secondary outcomes included body mass index (BMI), body weight, depression, lipid profile, and glycated hemoglobin (HbA1c) levels. Mean difference (MD) with 95% confidence intervals (CI) were pooled using appropriate methods.

Results: Three RCTs involving 177 patients were included, with 49% receiving intervention. There was no statistically significant difference between groups in binge eating (MD -1.25; 95% CI -5.61 to 3.11; 0=0.57), BMI (MD -2.24; 95% CI -8.01 to 3.53; p=0.45), depression (MD -0.81; 95% CI -3.48 to 1.87; p=0.55), or total cholesterol (MD -9.98; 95% CI -21.31 to 3.34; p=0.15). A potential benefit was observed in HbA1c levels (MD -0.10; 95% CI -0.28 to 0.08; p=0.26).

Conclusion: This meta-analysis found no significant benefit of bupropion-naltrexone over placebo in reducing binge-eating episodes or improving metabolic and psychological outcomes. A possible effect on HbA1c levels warrants further investigation.