Phenytoin treatment of the binge-eating syndrome

Nineteen subjects completed a 12-week double-blind crossover study comparing phenytoin with placebo in the treatment of severe binge eating. In the placebophenytoin sequence the number of binges decreased during phenytoin treatment from both placebo and pretreatment levels. However, in the phenytoin-placebo sequence, not only did phenytoin reduce the number of binges from pretreatment levels, but there was no reversal of this effect during the placebo period. This sequential effect was unexpected and is still unexplained. The mechanism of phenytoin action and the significance of EEG abnormalities found in 7 of the subjects remain uncertain.