Polaprezinc (Zinc-L-Carnosine Complex) as an Add-on Therapy for Binge Eating Disorder and Bulimia Nervosa, and the Possible Involvement of Zinc Deficiency in These Conditions: A Pilot Study

J Clin Psychopharmacol. 2020 Nov/Dec;40(6):599-606. doi: 10.1097/JCP.0000000000001284.


Background: Zinc plays an important role in appetite regulation. L-Carnosine, an endogenous dipeptide, may also regulate eating behavior via its histaminergic and antiglutamatergic properties. Polaprezinc (zinc-L-carnosine complex) is a medication for gastric ulcers. A small case series reported successful treatment of binge eating with add-on polaprezinc.

Methods: This was an open trial of add-on polaprezinc in patients with binge eating disorder (BED; n = 22) or bulimia nervosa (BN; n = 7) receiving antidepressants. A 4-week baseline period was followed by a 16-week polaprezinc treatment at 150 mg/d (containing 34 mg zinc and 116 mg L-carnosine) in addition to ongoing psychotropic medications. We also assessed their zinc status via a laboratory index and zinc deficiency-related symptoms.

Results: At the study end, both conditions showed a significant reduction in the 4-week frequency of combined objective and subjective binge eating episodes, the 4-week frequency of days when at least 1 such episode occurred (only in BED), several aspects of eating disorder psychopathology (rated by the Eating Disorder Examination-Questionnaire), and comorbid depressive symptoms (rated by the 16-item Quick Inventory of Depressive Symptomatology [Self-Report]). Serum copper/zinc ratio decreased from 1.4 to 1.1 on average in both conditions. All patients had multiple zinc deficiency-related symptoms at baseline that substantially improved after polaprezinc treatment. Overall, the effectiveness of polaprezinc was greater in BED patients than in BN patients, with minor adverse effects.

Conclusions: These findings offer preliminary evidence for the effectiveness of polaprezinc in treating BED and BN and suggest the involvement of zinc deficiency in these conditions.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antidepressive Agents / adverse effects
  • Antidepressive Agents / therapeutic use*
  • Binge-Eating Disorder / blood
  • Binge-Eating Disorder / diagnosis
  • Binge-Eating Disorder / drug therapy*
  • Binge-Eating Disorder / psychology
  • Biomarkers / blood
  • Bulimia Nervosa / blood
  • Bulimia Nervosa / diagnosis
  • Bulimia Nervosa / drug therapy*
  • Bulimia Nervosa / psychology
  • Carnosine / adverse effects
  • Carnosine / analogs & derivatives*
  • Carnosine / therapeutic use
  • Dietary Supplements* / adverse effects
  • Drug Therapy, Combination
  • Feeding Behavior / drug effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Organometallic Compounds / adverse effects
  • Organometallic Compounds / therapeutic use*
  • Pilot Projects
  • Prospective Studies
  • Time Factors
  • Tokyo
  • Treatment Outcome
  • Young Adult
  • Zinc / blood
  • Zinc / deficiency*
  • Zinc Compounds / adverse effects
  • Zinc Compounds / therapeutic use


  • Antidepressive Agents
  • Biomarkers
  • Organometallic Compounds
  • Zinc Compounds
  • polaprezinc
  • Carnosine
  • Zinc