Anorexia nervosa obsessive-compulsive disorder

Enoch MA, Kaye WH, Rotondo A, Greenberg BD, Mnrphy DL, Goldman D (1998) 5-HT2A promoter polymorphism -1438G/A, anorexia nervosa, and obsessive-compulsive disorder. Lancet 351 1785-1786... 

Enoch, M., Kaye, W, Ozaki, N., Mazzanti, C., Rotondo, A., Greenberg, B., Altemus, M., Murphy, D., and Goldman, D. (1998) Replication of an association between 5-HT2A promoter polymorphism — 1438G/A and anorexia nervosa, and association with obsessive-compulsive disorder. Lancet 351 1785-1786. 

Therapeutic uses The primary indication for fluoxetine is depression, where it is as effective as the tricyclic antidepressants. Fluoxetine is effective in treating bulimia nervosa and obsessive-compulsive disorder. The drug has been used for a variety of other indications, including anorexia nervosa, panic disorder, pain associated with diabetic neuropathy, and for premenstrual syndrome. 

Disorders that would formerly have been grouped under neuroses include depression in the absence of psychotic s)nnptoms, anxiety disorders (e.g. panic disorder, generalised anxiety disorder, obsessive-compulsive disorder, phobias and post-traumatic stress disorder), eating disorders (e.g. anorexia nervosa and bulimia nervosa) and sleep disorders. 

Anorectics often exhibit a host of obsessions and compulsions (regarding eating—sizes and portions, times for meals, body weight)—yet two notable differences exist between anorectics and OCD patients. Obsessive-compulsive disorder patients almost always admit that the worries and rituals are irrational, whereas most anorectics don t appreciate the irrationality of their acts. Also, medications found to be effective for OCD generally are not effective in the treatment of anorexia nervosa. 

Central hypoventilation syndrome, anorexia nervosa, bulimia nervosa, memory impairment, obsessive-compulsive disorder... 

SSRIs are agents of choice in obsessive-compulsive disorder and in the syndromes of impulse dyscontrol or obsessive preoccupations (e.g., compulsive gambling, trichotillomania, bulimia, but usually not anorexia nervosa and body dysmorphic disorder). Despite their hmited benefits, SSRIs offer an important advance in the medical treatment of these often chronic and sometimes incapacitating disorders. The effectiveness of pharmacological treatment for these disorders is greatly enhanced by use of behavioral treatments. 

In 1987, the United States Food and Dmg Administration (FDA) approved the use of fluoxetine for the treatment of depression and this derivative is now considered to be the prototype of a dmg class called selective serotonin reuptake inhibitors (SSRIs). As the name suggests, this term refers to the reuptake blockage of serotonin into the pre-synaptic membrane in order to indirectly increase neurotransmitter availability. A number of these derivatives showed beneficial effects for the treatment of a variety of additional conditions such as obsessive-compulsive disorders (OCD), bulimia nervosa, anxiety disorders, obesity, anorexia, post-traumatic stress disorders (PTSD) and others. SSRIs have become the first-line therapy for depression, which is based on improved side effect profiles when compared with TCA derivatives or MAOIs. A number of adverse effects are described in the pharmacological literature and include sexual dysfunction. 

---