Aripiprazole, a partial dopamine agonist to improve adolescent anorexia nervosa—A case series

Frank, Guido

doi:10.1002/eat.22485

Cited by 25 publications

(28 citation statements)

References 23 publications

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“…A few case reports suggest that aripiprazole -a partial dopamine agonistmay also be effective in the treatment of AN [125][126][127]. In a chart review of 75 patients with AN who received either olanzapine or aripiprazole, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size [128].…”

Section: Antipsychoticsmentioning

confidence: 99%

“…In a chart review of 75 patients with AN who received either olanzapine or aripiprazole, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size [128]. In the literature [125][126][127], relatively small doses were used. For example, in a case series published by Trunko et al [125] patients received aripiprazole doses of between 5 and 15 mg/d.…”

Section: Antipsychoticsmentioning

confidence: 99%

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Psychopharmacological advances in eating disorders

Himmerich

Treasure

2017

Expert Review of Clinical Pharmacology

100

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Anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) are the primary eating disorders (EDs). The only psychopharmacological treatment options for EDs with approval in some countries include fluoxetine for BN and lisdexamfetamine for BED. Given the high comorbidity and genetic correlations with other psychiatric disorders, it seems possible that novel medications for these conditions might also be effective in EDs. Areas covered: The current scientific literature has increased our understanding of how medication could be beneficial for patients with EDs on a molecular, functional and behavioral level. On the basis of theoretical considerations about neurotransmitters, hormones and neural circuits, possible drug targets for the treatment of EDs may include signal molecules and receptors of the self-regulatory system such as serotonin, norepinephrine and glutamate, the hedonic system including opioids, cannabinoids and dopamine and the hypothalamic homeostatic system including histamine, ghrelin, leptin, insulin, and glucagon-like peptide-1. Expert commentary: The latest research points to an involvement of both the immune and the metabolic systems in the pathophysiology of EDs and highlights the importance of the microbiome. Therefore, the next few years may unveil drug targets for EDs not just inside and outside of the brain, but possibly even outside of the human body.

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Section: Antipsychoticsmentioning

confidence: 99%

Section: Antipsychoticsmentioning

confidence: 99%

Psychopharmacological advances in eating disorders

Himmerich

Treasure

2017

Expert Review of Clinical Pharmacology

100

View full text Add to dashboard Cite

show abstract

“…This could have relevance for anorexia nervosa treatment and improve psychotherapy outcomes in this disorder. Three case reports supported benefits from prescription of the partial dopamine D2 receptor agonist aripiprazole in adults and youth with the disorder (Aragona, 2007;Frank, 2016a;Trunko, Schwartz, Duvvuri, & Kaye, 2011). One retrospective study suggested that the combination of a serotonin reuptake inhibitor (SSRI) with an atypical antipsychotic might reduce anorexia nervosa-related cognitions but did not show benefits for weight gain (Marzola et al, 2015).…”

Section: A R I P Ip R a Z O L E I N A N O R E X Ia N E R V O S Amentioning

confidence: 99%

The partial dopamine D2 receptor agonist aripiprazole is associated with weight gain in adolescent anorexia nervosa

Frank

Shott

Hagman

et al. 2017

Intl J Eating Disorders

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Objective Finding medication to support treatment of anorexia nervosa has been difficult. Neuroscience based approaches may help in this effort. Recent brain imaging studies in adults and adolescents with anorexia nervosa suggest that dopamine related reward circuits are hypersensitive and could provide a treatment target. Method Here we present a retrospective chart review of 106 adolescents with anorexia nervosa some of whom were treated with the dopamine D2 receptor partial agonist aripiprazole during treatment in a specialized eating disorder program. Results The results show that aripiprazole treatment was associated with greater increase in body mass index (BMI) during treatment. Discussion The use of dopamine receptor agonists may support treatment success in anorexia nervosa and should be further investigated.

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“…One case report in a sample of six patients with AN showed that a low dose of the dopamine agonist levodopa was helpful for weight gain in four patients, while the two non-responders maintained their weight [162]. Other evidence for dopamine agonists comes from case reports that suggest that the dopamine receptor partial agonist aripiprazole at a relatively low dose can reduce fear of weight gain and support AN treatment outcome [85, 84]. …”

Section: New Approaches To Medication Intervention In Anmentioning

confidence: 99%

“…In support of the low-dose approach is a study of AN that administered low-dose olanzapine to 13 patients and found that the medication showed indications supporting weight gain and reducing hyperactivity. Similarly, case reports of aripiprazole in AN suggest the use of low dosages [85]. Taking this small amount of information into consideration, it might be best to start medication below the typical dosage and slowly up-titrate, depending on clinical response.…”

Section: New Approaches To Medication Intervention In Anmentioning

confidence: 99%

The Role of Psychotropic Medications in the Management of Anorexia Nervosa: Rationale, Evidence and Future Prospects

Frank

Shott

2016

CNS Drugs

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Anorexia nervosa is a severe psychiatric disorder without approved medication intervention. Every class of psychoactive medication has been tried to improve treatment outcome; however, randomized controlled trials have been ambiguous at best and across studies have not shown robust improvements in weight gain and recovery. Here we review the available literature on pharmacological interventions since anorexia nervosa came to greater public recognition in the 1960s. This will include a critical review of why those trials may not have been successful. We further provide a neurobiological background for the disorder and discuss how cognition, learning and emotion-regulating circuits could become treatment targets in the future. Making every effort to develop effective pharmacological treatment options for anorexia nervosa is imperative, as it continues to be a complex psychiatric disorder with high disease burden and mortality.

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Aripiprazole, a partial dopamine agonist to improve adolescent anorexia nervosa—A case series

Cited by 25 publications

References 23 publications

Psychopharmacological advances in eating disorders

Psychopharmacological advances in eating disorders

The partial dopamine D2 receptor agonist aripiprazole is associated with weight gain in adolescent anorexia nervosa

The Role of Psychotropic Medications in the Management of Anorexia Nervosa: Rationale, Evidence and Future Prospects

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