Clinical psychopharmacology of eating disorders: a research update

Abstract

The paper presents a critical review (with search date 2010) of the major psychotropic medications assessed in eating disorders, namely antipsychotics, antidepressants, mood-stabilizing medications, anxiolytic and other agents. The evidence of efficacy of drug treatments is mostly weak or moderate. In addition, attrition rates are usually higher than for psychotherapies. However, there is support for use of antidepressants, particularly high-dose fluoxetine in bulimia nervosa, and anticonvulsants (topiramate) for binge-eating disorder. Low-dose antipsychotic medication may be clinically useful as adjunct treatment in acute anorexia, particularly where there is high anxiety and obsessive eating-related ruminations and failure to engage, but more trials are needed. Drug therapies such as topiramate and anti-obesity medication may aid weight loss in obese or overweight patients with binge-eating disorder; however, common or potentially serious adverse effects limit their use.

Medical Complications of Anorexia Nervosa and Bulimia

“…Low-dose antipsychotic medications may be useful in treating delusional beliefs regarding body image, intense ruminations about food, and the hyper-arousal and as well as anxiety induced by having to face weight restoration. 37,38 Although atypical antipsychotic medications promote weight gain in normal weight individuals, they do not have this effect in patients with anorexia nervosa. 35,39 However, patients with eating disorders may not accept reassurance in this regard.…”

“…32, 37 The effect of fluoxetine in treating the symptoms of bulimia nervosa appears to be independent of its effects on mood, and is reportedly related to the effects of the medication on satiety, thereby reducing binge eating. 41 …”

Treatment of anorexia nervosa: a multimethod investigation translating experimental neuroscience into clinical practice

“…Such patients are considered to be resistant to all forms of treatment. 221,222 The sample was powered to detect only moderate overall differences in patient outcome. With 134 carers in each group and an alpha level of 0.025 (adjusting for multiple primary outcomes), we had 80% power to detect an ES of 0.38.…”

Role of Community Nurses in Improving Caregivers' Ability in Caring Children with ARFID (Avoidant Restrictive Food Intake Disorder)

“…The prevalence of children suffering from eating disorder is 15% in female children and 3% in male children (Hay & Claudino, 2012), 30% in female children and 15% in male children (Campbell & Peebles, 2014), 5% -14% and potentially increase to 22.5% Norris & Katzman, 2015). Among six-to-fifteen-month-old infants, it is reported by caregiver that 6% of them suffer from eating disorder and this figure will increase to 25 -40% in the following stage of development (Sacrato, Pellicciari, & Franzoni, 2010).…”