Abstract
People with anorexia nervosa have abnormal eating behaviors with associated cognitive misconceptions concerning body image and disturbances of mood, as well as alterations of a wide variety of hormonal and metabolic systems (see Chapter 5 for a further description of anorexia nervosa). Currently, many investigators conceptualize these disorders as being due to a combination of cultural-social, psychological, and biological factors (1,2). In general, the response of patients with anorexia nervosa to psychotherapeutic or pharmacological treatments has been limited. The purpose of this chapter is to review the evidence for the efficacy of available drug treatments for anorexia nervosa and guidelines for pharmacological therapy (Table 1).
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References
Garner DM, Garfinkel PE. The eating attitudes test: an index of the symptoms of anorexia nervosa. Psychol Med 1979; 9: 273–279.
Ploog D. The Psychobiology of Anorexia Nervosa. In: Pirke KM, Ploog D, eds. Springer-Verlag, Berlin, NY, 1984, pp. 1–3.
Johanson AJ, Knorr NJ. L-Dopa as treatment for anorexia nervosa. In: Vigersky RA, ed. Anorexia Nervosa. Nervosa, Raven, New York, NY, 1977, pp. 363–372.
Redmond DE, Swann A, Heninger GR. Phenoxybenzamine in anorexia nervosa. Lancet 1976; 2: 397.
Green RS, Rau JH. Treatment of compulsive eating disturbances with anticonvulsant medication. Am J Psychol 1974; 131: 428–432.
Green RS, Rau JH. The use of diphenylhydantoin in compulsive eating disorders: further studies in anorexia nervosa. In: Vigersky RA, ed. Anorexia Nervosa. Nervosa, Raven, New York, NY, 1977, pp. 377–385.
Wulliemier JF, Rossel F, Sinclair K. La therapie comportementale de l’ anorexia. J Psychsom Res 1975; 19: 267–272.
Moore R, Mills IH, Forster A. Naloxone in the treatment of anorexia nervosa: Effect on weight gain and lipolysis. J Roy Soc Med 1981; 74: 129–131.
Halmi KA. Anorexia nervosa. In: Kaplan HI, Freedman AM, Sadock RJ, eds. Comprehensive Textbook of Psychiatry, Vol. 2, 3rd ed. Williams & Wilkins, Baltimore, MD, 1980.
Hsu LKG. The treatment of anorexia nervosa. Am J Psychiatry 1986; 143: 573–581.
Russell GFM, Szmukler GI, Dare C, Eisler I. An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Arch Gen Psychiatry 1987; 44: 1047–1056.
Gowers S, Norton K, Halek C, Crisp AH. Outcome of outpatient psychotherapy in a random allocation treatment study of anorexia nervosa. Int J Eat Disord 1994; 15: 165–177.
Treasure J, Todd G, Brolly M, Tiller J, Nehmed A, Denman F. A pilot study of a randomized trail of cognitive analytical therapy vs educational behavioral therapy for adult anorexia nervosa. Behav Res Ther 1995; 33 (4): 363–367.
Kaye WH, Weltzin TE, Hsu LKG, Sokol MS, McConaha C, Plotnicov KH. Relapse prevention with fluoxetine in anorexia nervosa: a double-blind placebo-controlled study. Abstracts of the 1996 Meeting at the American Psychiatric Association, Washington, DC, p. 178.
Vandereychken W, Pierlott R. Pimozide combined with behavior therapy in the short-term treatment of anorexia nervosa. Acta Psychiatr Scand 1982; 66: 445–450.
Vandereychken W. Neuroleptics in the short-term treatment of anorexia nervosa: a double-blind, placebo controlled study with sulphide. Brit J Psychol 1984; 144: 288–292.
Gross H, Ebert MH, Faden VB. A double-blind trial of delta-9-tetrahydrocannabinol in primary anorexia nervosa. J Clin Psychopharm 1983; 3: 165–171.
Casper RC, Schlemmer RF, Javaid JI. A placebo-controlled, crossover study of oral clonidine in acute anorexia nervosa. Psychol Res 1987; 20: 249–260.
Szmukler GI, Young GP, Lichenstein M, Andrews JT. A serial study of gastric emptying in anorexia and bulimia nervosa. Aust N Z J Med 1990; 20: 220–225.
Domstad PA, Shih WJ, Humphries L, DeLand FH, Digenis GA. Radionuclide gastric emptying studies in patients with anorexia nervosa. J Nucleic Med 1987; 28: 816–819.
Russell DM, Freedman ML, Feiglin DH, Jeejeebhoy KN, Swinson RP, Garfinkel PE. Delayed gastric emptying and improvement with domperidone in a patient with anorexia nervosa. Am J Psychiatry 1983; 140: 1235–1236.
Saleh JW, Lebwohl P. Metoclopramide-induced gastric emptying in patients with anorexia nervosa. Am J Gastroenterol 1980; 74: 127–132.
Stacher G, Bergmann H, Wiesnagrotzki S, Kiss A, Schneider C, Mittelbach G, et al. Intravenous cisapride accelerates delayed gastric emptying and increases antral contraction amplitude in patients with primary anorexia nervosa. Gastroenterology 1987; 92: 1000–1006.
Strober M, Katz JL. Depression in the eating disorders: A review and analysis of descriptive, family, and biological findings. In: Garner DM, Garfinkel PE, eds. Diagnostic Issues in Anorexia Nervosa and Bulimia Nervosa. Brunner/Mazel, New York, NY 1988.
Rothenberg A. Differential diagnosis of anorexia nervosa and depressive illness: a review of 11 studies. Compr Psychiatry 1988; 29: 427–432.
Swift WJ, Andrews D, Barklage NE The relationship between affective disorder and eating disorders: a review of the literature. Am J Psychol 1986; 143: 290–299.
Strober M. Personality and symptomatological features in young, nonchronic anorexia nervosa patients. J Psychosom Res 1980; 24: 353–359.
Hudson JI, Pope HG, Jonas JM, Yurgelum-Todd D. Phenomenologic relationship of eating disorders to major affective disorder. Psychiatry Res 1983; 9: 345–354.
Solyom LS, Freeman RJ, Miles JE. A comparative psychometric study of anorexia nervosa and obsessive neurosis. Can J Psychiatry 1982; 27: 282–286.
Toner BB, Garfinkel PE, Garner DM. Long term follow-up of anorexia nervosa. Psychosom Med 1986; 48: 520–529.
Kasvikis YG, Tsakiris F, Marks IM. Past history of anorexia nervosa in women with obsessive compulsive disorder. Int J Eat Disord 1986; 5: 1069–1075.
Kaye WH, Gwirtsman HE, George DT, Ebert MH. Altered serotonin activity in anorexia nervosa after long-term weight restoration. Arch Gen Psych 1991; 48: 556–562.
Zohar J, Insel TR. Obsessive-compulsive disorder: psychobiological approaches to diagnosis, treatment, and pathophysiology. Biol Psychiatry 1987; 22: 667–687.
Moore R. Amitriptyline therapy in anorexia nervosa. Am J Psychol (1977); 13: 1303–1304.
Needlemen HL, Waber D. The use of amitriptyline in anorexia nervosa. In: Vigersky RA, ed. Anorexia Nervosa. Raven, New York, NY, 1977.
Beiberman J, Herzog DB, Rivinus TM, Harper GP, Ferber RA, Rosenbaum JF, et al. Amitriptyline in the treatment of anorexia nervosa: a double-blind placebo-controlled study. J Clin Psychopharm 1985; 5: 10–16.
Gross HA, Ebert MH, Faden VB, Goldberg SC, Nee LE, Kaye WH. A double blind controlled trial of lithium carbonate in primary anorexia nervosa. J Clin Psychopharmacol 1981; 1: 376–381.
Kaye WH, Weltzin T, Hsu LKG. Anorexia nervosa. In: Hollander E, ed. Obsessive-Compulsive Related Disorders. American Psychiatric Press, Washington, DC, 1993, pp. 49–70.
Hollander E, Liebowitz MR, Winchel R, Klumler A, Klein DF. Treatment of body-dysmorphic disorder with serotonin reuptake blockers. Am J Psychiatry 1989; 146: 768–770.
Srinivasagam NM, Plotnicov KH, Greeno C, Weltzin TE, Rao R, Kaye WH. Persistent perfectionism, symmetry, and exactness in anorexia nervosa after long-term recovery. Am J Psychiatry, 1995; 152: 1630–1634.
Crisp AH, Lacey JH, Crutchfield M. Clomipramine and “drive” in people with anorexia nervosa. Br J Psychiatry 1987; 150: 355–358.
Stone CA, Wenger HC, Ludden CT. Antiserotonin-antihistamine properties of cyproheptadine. J Pharm Exp Ther 1961; 131: 73–81.
Goldberg SC, Halmi KA, Eckert ED. Cyproheptadine in anorexia nervosa. Brit J Psychol 1979; 134: 67–70.
Halmi KA, Eckert E, Falk JR. Cyproheptadine for anorexia nervosa. Lancet 1982; 1: 1357–1358.
Halmi KA, Eckert ED, LaDu, TJ, Cohen J. Anorexia nervosa: treatment efficacy of cyproheptadine and amitriptyline. Arch Gen Psychiatry 1986; 43: 177–181.
Gwirtsman HE, Guze BH, Yager J, Gainsley B. Fluoxetine treatment of anorexia nervosa: an open clinical trial. J Clin Psychiatry 1990; 51: 378–382.
Kaye WH, Weltzin TE, Hsu LKG, Bulik CM. An open trial of fluoxetine in patients with anorexia nervosa. J Clin Psych 1991; 52: 464–471.
Ferguson CP, La Via MC, Crossan PJ, Kaye WH. Are SSRI’s effective in underweight anorexia nervosa? Int J Eat Disord, in press.
Attia E, Haiman C, Walsh BT, Flater SR. Does fluoxetine augment the inpatient treatment of anorexia nervosa? Am J Psychiatry 1998; 155: 548–551.
Schweiger V, Warnoff M, Pahl J, Pirke K. Effects of carbohydrate and protein meals on plasma large neutral amino acids, glucose and insulin plasma levels of anorectic patients. Metabolism 1986; 35 (2): 938–943.
Kaye WH, Gwirtsman HE, George DT, Jimerson DC, Ebert MH. CSF 5-HIAA concentrations in anorexia nervosa: reduced values in underweight subjects normalize after weight gain. Biol Psychiatry 1988; 23 (1): 102–105.
Fink G, Summner BEH. Oestrogen and mental state. Nature 1996; 383: 306.
McQueen JK, Wilson H, Dow RC, Fink GJ. Oestradiol-17 beta increases serotonin transporter (SERT) binding sites and SERT mRNA expression in discrete regions of female rat brain. J Physiol (Lond) 1996; 495: 114.
Tollefson GD. Selective serotonin reuptake inhibitors. In: Schatzberg AF, Memeroff CB, eds. Textbook of Psychopharmacology. American Psychiatric Press, Washington, DC, 1995.
Kaye WH, Ebert MH, Raleigh M, Lake R. Abnormalities in CNS monoamine metabolism in anorexia nervosa. Arch Gen Psychiatry 1984; 41 (4): 350–355.
Pollice C, Kaye WH, Greeno CG, Weltzin TE. Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa. Int J Eat Disord 1997; 21: 367–376.
American Psychiatric Association. Practice guideline for eating disorders: I. disease definition, epidemiology, and natural history. Am J Psychol 1993; 150 (2): 212–228.
Zohar J, Insel TR, Zohar-Kadouch RC, Hill JL, Murphy DL. Serotonergic responsivity in obsessive-compulsive disorder. Arch Gen Psychiatry 1988; 45: 167–172.
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Kaye, W.H. (1999). Pharmacologic Therapy for Anorexia Nervosa. In: Goldstein, D.J. (eds) The Management of Eating Disorders and Obesity. Nutrition ◊ and ◊ Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-694-2_7
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DOI: https://doi.org/10.1007/978-1-59259-694-2_7
Publisher Name: Humana Press, Totowa, NJ
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