Anorexia nervosa treatment

Halmi, K.A., Eckert, E.D., Tadu, T, and Cohen, J. (1986) anorexia nervosa treatment efficacy of cyproheptadine and amitriptyline. Arch Gen Psychiatry 43 177-181. 

Jensen VS, Mejihede A. Anorexia nervosa treatment with olanzapine [Letter]. Br J Psychiatry 2000 177 87. 

Bupropion sustained release (SR) is an effective smoking-cessation treatment. It is contraindicated in patients with a seizure disorder, a current or prior diagnosis of bulimia or anorexia nervosa, and use of a monoamine oxidase inhibitor within the previous 14 days. It can be used in combination with NRT. 

Attia E, Schroeder L. Pharmacologic treatment of anorexia nervosa. Int J Eat Disord 2005 37(Supplement) S60-S63. 

Hypersensitivity to the drug seizure disorder current or prior diagnosis of bulimia or anorexia nervosa concurrent administration of a monoamine oxidase inhibitor (MAOl) (at least 14 days should elapse between discontinuation of an MAOl and initiation of treatment with bupropion) in patients being treated with other bupropion products (eg, for smoking cessation) in patients undergoing abrupt discontinuation of alcohol or sedatives (including benzodiazepines). 

Bell, R. (1985) Holy Anorexia. Chicago University of Chicago Press. Bemis, K.N. (1978) Current approaches to the etiology and treatment of anorexia nervosa. Psychol Bull 85 593-617. 

Solyom, L., Solyon, C., Ledwidge, B. (1989) Fluoxetine treatment of low weight chronic anorexia nervosa. / Clin Psychopharmacol 10 421 25. 

Serfaty, M., Jurhington, D., Heap, M., Ledsham, L., and Jolley, E., (1999) Cognitive thetapy vs. dietaty counselling in the outpatient treatment of anorexia nervosa. Europ. Eating Dis. Rev. 7 334-350. 

Vandereycken, W. (1984) Neuroleptics in the short term treatment of anorexia nervosa a double-blind placebo-control study with sulpiride. Br ] Psychiatry 144 288-292. 

Vandereycken, W. and Nierloo, T.R. (1982) Pimozide combined with behavior therapy in the short term treatment of anorexia nervosa. Acta Psychiatr Scand 66 445-450. 

Psychotropic medication use is associated more with causing difficulties with eating rather than as a treatment for eating disorders. None of the medications investigated in the treatment of primary anorexia nervosa have been shown to be efficacious. Pica is defined as the eating of non-food substances. In the Expert Consensus survey (Rush and Frances, 2000) 63% of the respondents stated that no medication treatment is indicated for this disorder. Should medication be considered, then SSRI medications were most commonly endorsed. Another alternative is treatment with mineral or nutritional supplements, such as zinc or iron. 

Levine J, Barak Y, Gonsalves M, et al A double-blind controlled trial of inositol treatment of depression. Am J Psychiatry 152 792-794, 1995a Levine J, Pomerantz T, Stier S, et al Lack of effect of 6 g inositol treatment on post-ECT cognitive function in humans. J Psychiatr Res 29 487-489, 1995b Levy A, Zohar J, Belmaker RH The effect of chronic lithium pretreatment on rat brain muscarinic receptor regulation. Neuropharmacology 21 1199-1201, 1983 Levy AB, Dixon KN, Schmidt H Sleep architecture in anorexia nervosa and bulimia. Biol Psychiatry 23 99-101, 1988... 

There are several reasons to anticipate that antidepressants might be effective in the treatment of anorexia nervosa. Malnutrition has been shown to produce a syndrome that is virtually indistinguishable from depression, with anhedonia, weight loss, motor retardation, anergia, and decreased ability to think or concentrate. In addition, the high association of co-morbidity between anorexia nervosa and mood disturbances, as well as the preponderance of mood disorders in first-degree relatives of those with anorexia nervosa, have led some clinicians to consider and treat this condition as a depressive variant. 

Antipsychotics also have been used in the treatment of anorexia nervosa. The apparent role of dopamine in feeding and satiety involves increased receptor activity, producing symptoms similar to those found in anorexia nervosa. Thus, it seems reasonable to use dopamine antagonists to alter these behaviors. It also seems appropriate to use the sedative side effects of these drugs to decrease anxiety associated with eating. 

A meta-analysis of eating disorder programs suggests that medications alone fail to produce consistent weight gain in anorexia nervosa ( 510). Better results appear possible if medication is integrated into a comprehensive treatment approach, which includes the following ... 

Whereas attempts to treat anorexia nervosa pharmacologically have generally been disappointing, the role of medication in the treatment of bulimia nervosa is more promising. There are several positive studies published, many of which used larger sample sizes and were well controlled. Most have centered on the possible efficacy of the following ... 

The role of medication in the treatment of bulimia nervosa seems better established than its role in the treatment of anorexia nervosa. The American Psychiatric Association Practice Guideline for Eating Disorders ( 510) suggests that antidepressants may be useful in bulimia nervosa with or without depression. They may be particularly helpful, however, in those with depression, anxiety, obsessions, or who have failed psychosocial therapies. 

Biederman J, Herzog DB, Rivinus TM, et al. Amitriptyline in the treatment of anorexia nervosa a double-blind, placebo-controlled study. J Clin Psychopharmacoi 1985 5 10-16. 

Gwirtsman HE, Guze BH, Vager J, et al. Fluoxetine treatment of anorexia nervosa an open clinical trial. J Clin Psychiatry 1990 51 378-382. 

Powers PS, Santana CA, Bannon YS. Olanzapine in the treatment of anorexia nervosa an open label trial. Int J Eat Disord 2002 32(2) 146-54. 

Studies show that the SSRIs may help alcoholics reduce the amount of alcohol they consume and also increase the number of days they can abstain from alcohol. Patients with anorexia nervosa may also be helped by antidepressants. No other treatment has been approved by the FDA for this eating disorder, but the antidepressants are helping patients maintain their weight and avoid relapse. 

Orexin A (from the Greek orexis, "appetite") is a 33 amino acid neuropeptide connected by two disulfide bridges. Orexin A is a powerful stimulant forfood intake and gastric juice secretion. Scientists are studying orexin A to learn more about the regulation of appetite and eating, hoping to learn more about causes and potential treatments for anorexia nervosa. 

With a typical onset in midadolescence, this predominantly female disorder has a lifetime prevalence of approximately 0.5% (Walsh, 2001). Patients who suffer with anorexia nervosa fail to maintain at least 85% of their expected weight they have great fear of gaining weight, and they resist any treatment that urges them to return to a goal of approximately 90% of predicted weight. The patient appears unduly thin and may have... 

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