Case Report: Rapid Remission of Adolescent Binge-Eating Disorder After Over-the-Counter Glutamatergic Augmentations to Bupropion

Background: Binge-eating disorder in teenagers often lingers even after they try the usual medicines and diet plans, especially when low mood is part of the picture. Glutamate-based treatments are attracting interest because they seem to steady reward circuits and lift mood more quickly than standard approaches. Case Presentation: A 16-year-old girl illustrates this possibility. She was bingeing two or three times a day, occasionally making herself vomit, skipping school, and feeling moderately depressed (PHQ-9 = 17). We had already arranged to start bupropion XL 150 mg for her mood and depressive symptoms. On top of it we added three off-the-shelf products: dextromethorphan 60 mg (the cough-suppressant strength sold in pharmacies), piracetam 1 200 mg, and the amino-acid supplement L-glutamine 1 000 mg. She did not receive new therapy sessions or a formal meal plan during the observation period. Results: The change was swift. Within a week the binge-and-purge cycle stopped and has not returned. Two weeks in, she was back at school every day and eating regular meals (PHQ-9 = 12). Six weeks after the start, depressive symptoms were minimal (PHQ-9 = 8); she had re-engaged in classes and sports and managed weekends at home without relapse. Apart from a brief spell of mild restlessness, she felt well. Conclusion: This single case suggests that pairing bupropion with low-cost glutamatergic agents—dextromethorphan, piracetam, and L-glutamine—may offer a fast, practical route to remission for adolescents whose binge-eating and depression resist conventional care. Systematic studies are needed to see whether this accessible strategy can help others in the same situation.