Serotonin activity in anorexia nervosa after long-term weight restoration: response to D-fenfluramine challenge

Abstract

SYNOPSIS Abnormalities in central serotonin function have been implicated in the pathogenesis of anorexia nervosa. It is difficult, however, to separate neuroendocrine abnormalities induced by weight loss and malnutrition from those related primarily to the disorder itself. To minimize these influences, this study assessed long-term weight restored anorexics. A correlation between persistent eating-related psychopathology, co-morbid illness and serotonin dysfunction was sought. Nine female weight-restored out-patients who had previously fulfilled DSM-III-R criteria for anorexia nervosa and nine healthy controls participated. Following baseline estimation, prolactin and cortisol responses to 30 mg p.o. of D-fenfluramine were measured over a 5 h period. Eating related psychopathology was assessed using the Eating Disorders Inventory and Eating Attitudes Test. Depressive and obsessional symptoms were measured using the Beck Depressive and Maudsley Obsessive-Compulsive Inventories respectively. The Tridimensional Personality Questionnaire assessed impulsivity. The weight-restored anorexic group exhibited persistent eating-related psychopathology and significant co-morbid symptomatology. There was no difference between long-term weight restored anorexics and controls in their endocrine response to D-fenfluramine. Long-term weight-recovered anorexic subjects continued to exhibit behavioural and attitudinal disturbances characteristic of anorexia nervosa. The results suggest that abnormalities in 5HT activity do not contribute significantly to trait status in anorexia nervosa.

Neuropsychological study of underweight and “weight‐recovered” anorexia nervosa compared with bulimia nervosa and normal controls

“…The finding of significant depressive and anxiety symptoms in the ''weight-recovered'' AN group is in keeping with findings in other studies of ''weightrecovered'' AN, albeit mostly of 6-12 months' duration. [81][82][83] Participants in the AN and BN groups were chronically ill in terms of their mean illness durations. Although the inclusion criteria for the ''weight-recovered'' AN group required a minimum of 3 months at or above a BMI 18.5 kg/m 2 , the mean period of ''weight-recovery'' was 67.8 months (standard deviation 73.4 months) in keeping with longer-term periods of ''weight-recovery'' in other studies.…”

Altered 5-HT2A Receptor Binding after Recovery from Bulimia-Type Anorexia Nervosa: Relationships to Harm Avoidance and Drive for Thinness

“…First, studies of women who have recovered from an eating disorder avoid the confounding effects of malnutrition on 5-HT activity. Second, some, but not all studies, showed that a disturbance of 5-HT activity persists after recovery from an eating disorder (Kaye et al, 1991;O'Dwyer et al, 1996;Ward et al, 1998). Finally, certain behaviors, such as anxiety, perfectionism, and obsessionality, have been found to occur premorbidly, and persist after recovery from AN (Bulik et al, 1997;Casper, 1990;Deep et al, 1995;Srinivasagam et al, 1995;Strober, 1980).…”

Candidate genes for anorexia nervosa in the 1p33–36 linkage region: serotonin 1D and delta opioid receptor loci exhibit significant association to anorexia nervosa

“…[13][14][15] In fact, most studies have shown that individuals with AN have disturbances of central serotonin activity, [15][16][17] which persist after recovery. [18][19][20] The opioid system has been implicated in the modulation of feeding behavior in which opioid agonists and antagonists were injected into animals. [21][22][23][24] Some clinical studies have suggested that opioid antagonists may have beneficial effects on eating behavior symptoms in patients with eating disorders.…”