Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-24T17:34:14.608Z Has data issue: false hasContentIssue false

Psychopharmacological options for adult patients with anorexia nervosa

Published online by Cambridge University Press:  06 July 2015

Mario Miniati*
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Mauro Mauri
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Agnese Ciberti
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Michela Giorgi Mariani
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Donatella Marazziti
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
Liliana Dell’Osso
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
*
*Address for correspondence: Mario Miniati, MD, Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, 57 Via Roma, Pisa, Italy. (Email: [email protected])

Abstract

The aim of this review was to summarize evidence from research on psychopharmacological options for adult patients with anorexia nervosa (AN). Database searches of MEDLINE and PsycINFO (from January 1966 to January 2014) were performed, and original articles published as full papers, brief reports, case reports, or case series were included. Forty-one papers were screened in detail, and salient characteristics of pharmacological options for AN were summarized for drug classes. The body of evidence for the efficacy of pharmacotherapy in AN was unsatisfactory, the quality of observations was questionable (eg, the majority were not blinded), and sample size was often small. More trials are needed, while considering that nonresponse and nonremission are typical of patients with AN.

Type
Review Articles
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Simon, J, Schmidt, U, Pilling, S. The health service use and cost of eating disorders. Psychol Med. 2005; 35(11): 15431551.Google Scholar
2.Hudson, JI, Pope, HG Jr. Genetic epidemiology of eating disorders and co-occurring conditions: the role of endophenotypes. Int J Eat Disord. 2007; 40(Suppl): 7678.Google Scholar
3.Hoek, HW, Van Hoeken, D. Review of the prevalence and incidence of eating disorders. Int J Eat Disord. 2003; 34(4): 383396.Google Scholar
4.Hoek, HW. Incidence, prevalence and mortality of anorexia nervosa and other eating disorders. Curr Opin Psychiatry. 2006; 19(4): 389394.Google Scholar
5.Grucza, RA, Przybeck, TR, Cloninger, CR. Prevalence and correlates of binge eating disorder in a community sample. Compr Psychiatry. 2007; 48(2): 124131.CrossRefGoogle Scholar
6.Mitchinson, D, Hay, PJ. The epidemiology of eating disorders: genetic, environmental, and social factors. Clin Epidemiol. 2014; 17(6): 8997.Google Scholar
7.Machado, PP, Machado, BC, Gonçalves, S, Hoek, HW. The prevalence of eating disorders not otherwise specified. Int J Eat Disord. 2007; 40(3): 212217.CrossRefGoogle Scholar
8.Castellini, G, Lo Sauro, C, Mannucci, E, et al. Diagnostic crossover and outcome predictors in eating disorders according to DSM-IV and DSM-V proposed criteria: a 6-year follow-up study. Psychosom Med. 2011; 73(3): 270279.Google Scholar
9.Bulik, CM, Sullivan, PF, Fear, J, Pickering, A. Predictors of the development of bulimia nervosa in women with anorexia nervosa. J Nerv Ment Dis. 1997; 185(11): 704707.CrossRefGoogle ScholarPubMed
10.Eckert, ED, Halmi, KA, Marchi, P, Grove, W, Crosby, R. Ten-year follow-up of anorexia nervosa: clinical course and outcome. Psychol Med. 1995; 25(1): 143156.Google Scholar
11.Strober, M, Freeman, R, Morrell, W. The long-term course of severe anorexia nervosa in adolescents: survival analysis of recovery, relapse, and outcome predictors over 10–15 years in a prospective study. Int J Eat Disord. 1997; 22(4): 339360.Google Scholar
12.Eddy, KT, Dorer, DJ, Franko, DL, Tahilani, K, Thompson-Brenner, H, Herzog, DB. Diagnostic crossover in anorexia nervosa and bulimia nervosa: implications for DSM-V. Am J Psychiatry. 2008; 165(2): 245250.Google Scholar
13.Hoek, HW, van Hoeken, D. Review of the prevalence and incidence of eating disorders. Int J Eat Disord. 2003; 34(4): 383396.Google Scholar
14.Eating disorders. Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. National Clinical Practice Guideline Number CG9 developed by National Collaborating Centre for Mental Health commissioned by the National Institute for Clinical Excellence. London: The British Psychological Society & The Royal College of Psychiatrists; 2004.Google Scholar
15.Brambilla, F, Tortorella, A. Disturbi del comportamento alimentare. In: Marazziti D, ed. Psicofarmacoterapia Clinica. 5th ed.Rome: Giovanni Fioriti Editore; 2013: 183191.Google Scholar
16.American Psychiatric Association. Practice Guideline for the Treatment of Patients with Eating Disorders. 3rd ed. Washington, DC: American Psychiatric Association; 2006.Google Scholar
17.Steinhausen, HC. Treatment and outcome of adolescent anorexia nervosa. Horm Res. 1995; 43(4): 168170.Google Scholar
18.Smink, FR, van Hoeken, D, Hoeck, HW. Epidemiology of Eating Disorders: Incidence, Prevalence and Mortality Rates. Curr Psychiatry Rep. 2012; 14: 406414.Google Scholar
19.Biederman, J, Herzog, DB, Rivinus, TM, et al. Amitriptyline in the treatment of anorexia nervosa: a double-blind, placebo-controlled study. J Clin Psychopharmacol. 1985; 5(1): 1016.Google Scholar
20.Halmi, KA, Eckert, E, LaDu, TJ, Cohen, J. Anorexia nervosa: treatment efficacy of cyproheptadine and amitriptyline. Arch Gen Psychiatry. 1986; 43(2): 177181.Google Scholar
21.Lacey, JH, Crisp, AH. Hunger, food intake and weight: the impact of clomipramine on a refeeding anorexia nervosa population. Postgrad Med J. 1980; 56(1): 7985.Google Scholar
22.Crisp, AH, Lacey, JH, Crutchfield, M. Clomipramine and ‘drive’ in people with anorexia nervosa: an in-patient study. Br J Psychiatry. 1987; 150(3): 355358.Google Scholar
23.Hollander, E, Kim, S, Braun, A, Simeon, D, Zohar, J. Cross-cutting issues and future directions for the OCD spectrum. Psychiatry Res. 2009; 170(1): 36.Google Scholar
24.Phillips, KA, Friedman, MJ, Stein, DJ, Craske, M. Special DSM-V issues on anxiety, obsessive-compulsive spectrum, post-traumatic, and dissociative disorders. Depress Anxiety. 2010; 27(2): 9192.CrossRefGoogle ScholarPubMed
25.Ramacciotti, CE, Coli, E, Paoli, R, Marazziti, D, Dell’Osso, L. Serotonergic activity measured by platelet [3H] paroxetine binding in patients with eating disorders. Psychiatry Res. 2003; 118(1): 3338.Google Scholar
26.Gwirtsman, HE, Guze, BH, Yager, J, Gainsley, B. Fluoxetine treatment of anorexia nervosa: an open clinical trial. J Clin Psychiatry. 1990; 51(9): 378382.Google Scholar
27.Attia, E, Haiman, C, Walsh, BT, Flater, SR. Does fluoxetine augment the inpatient treatment of anorexia nervosa? Am J Psychiatry. 1998; 155(4): 548551.CrossRefGoogle ScholarPubMed
28.Barbarich, NC, McConaha, CW, Halmi, KA, et al. Use of nutritional elements to increase the efficacy of fluoxetine in the treatment of anorexia nervosa. Int J Eat Disord. 2004; 35(1): 1015.Google Scholar
29.Kaye, WH, Nagata, T, Weltzin, TE, et al. Double-blind placebo-controlled administration of fluoxetine in restricting- and restricting-purging-type anorexia nervosa. Biol Psychiatry. 2001; 49(7): 644652.Google Scholar
30.Walsh, BT, Kaplan, AS, Attia, E, et al. Fluoxetine after weight restoration in anorexia nervosa: a randomized controlled trial. JAMA. 2006; 295(22): 26052612.Google Scholar
31.Fassino, S, Leombruni, P, Daga, G, et al. Efficacy of citalopram in anorexia nervosa: a pilot study. Eur Neuropsychopharmacol. 2002; 12(5): 453459.Google Scholar
32.Safer, DL, Darcy, AM, Lock, J. Use of mirtazapine in an adult with refractory anorexia nervosa and comorbid depression: a case report. Int J Eat Disord. 2010; 44(2): 178181.Google Scholar
33.Safer, DL, Arnow, KD. Suprathreshold duloxetine for treatment-resistant depression, anorexia nervosa binge-purging type, and obsessive-compulsive disorder: a case report. Innov Clin Neurosci. 2012; 9(3): 1316.Google Scholar
34.Vandereycken, W. Neuroleptics in the short-term treatment of anorexia nervosa: a double-blind placebo-controlled study with sulpiride. Br J Psychiatry. 1984; 144(3): 288292.Google Scholar
35.Ramacciotti, CE, Dell’Osso, L, Paoli, RA, et al. Characteristics of eating disorder patients without a drive for thinness. Int J Eat Disord. 2002; 32(2): 206212.Google Scholar
36.Frieling, H, Römer, KD, Scholz, S, et al. Epigenetic dysregulation of dopaminergic genes in eating disorders. Int J Eat Disord. 2010; 43(7): 577583.Google Scholar
37.Cassano, GB, Miniati, M, Pini, S, et al. Six-month open trial of haloperidol as an adjunctive treatment for anorexia nervosa: a preliminary report. Int J Eat Disord. 2003; 33(2): 172177.Google Scholar
38.Mauri, M, Miniati, M, Mariani, MG, Ciberti, A, Dell’Osso, L. Haloperidol for severe anorexia nervosa restricting type with delusional body image disturbance: a nine-case chart review. Eat Weight Disord. 2013; 18(3): 329332.CrossRefGoogle ScholarPubMed
39.Dally, A, Sargant, W. Treatment and outcome of anorexia nervosa. Br Med J. 1966; 2(5517): 793795.Google Scholar
40.Ruggiero, GM, Laini, V, Mauri, MC, et al. A single blind comparison of amisulpride, fluoxetine and clomipramine in the treatment of restricting anorectics. Prog Neuropsychopharmacol Biol Psychiatry. 2001; 25(5): 10491059.Google Scholar
41.Vandereycken, W, Pierloot, R. Pimozide combined with behavior therapy in the short-term treatment of anorexia nervosa: a double-blind placebo-controlled cross-over study. Acta Psychiatr Scand. 1982; 66(6): 445450.Google Scholar
42.Powers, PS, Santana, CA, Bannon, YS. Olanzapine in the treatment of anorexia nervosa: an open label trial. Int J Eat Disord. 2002; 32(2): 146154.Google Scholar
43.Barbarich, NC, McConaha, CW, Gaskill, J, et al. An open trial of olanzapine in anorexia nervosa. J Clin Psychiatry. 2004; 65(11): 14801482.Google Scholar
44.Mondraty, N, Birmingham, CL, Touyz, S, Sundakov, V, Chapman, L, Beumont, P. Randomized controlled trial of olanzapine in the treatment of cognitions in anorexia nervosa. Australas Psychiatry. 2005; 13(1): 7275.Google Scholar
45.Malina, A, Gaskill, J, McConaha, C, et al. Olanzapine treatment of anorexia nervosa: a retrospective study. Int J Eat Disord. 2003; 33(2): 234237.CrossRefGoogle ScholarPubMed
46.Bissada, H, Tasca, GA, Barber, AM, Bradwejn, J. Olanzapine in the treatment of low body weight and obsessive thinking in women with anorexia nervosa: a randomized, double-blind, placebo-controlled trial. Am J Psychiatry. 2008; 165(10): 12811288.Google Scholar
47.Attia, E, Kaplan, AS, Walsh, BT, et al. Olanzapine versus placebo for outpatients with anorexia nervosa. Psychol Med. 2011; 41(10): 21772182.Google Scholar
48.Brambilla, F, Monteleone, P, Maj, M. Olanzapine-induced weight gain in anorexia nervosa: involvement of leptin and ghrelin secretion? Psychoneuroendocrinology. 2007; 32(4): 402406.Google Scholar
49.Brambilla, F, Garcia, CS, Fassino, S, et al. Olanzapine therapy in anorexia nervosa: psychobiological effects. Int Clin Psychopharmacol. 2007; 22(4): 197204.Google Scholar
50.Hansen, L. Olanzapine in the treatment of anorexia nervosa. Br J Psychiatry. 1999; 175(6): 592.Google Scholar
51.Jensen, VS, Mejlhede, A. Anorexia nervosa: treatment with olanzapine. Br J Psychiatry. 2000; 177(1): 87.Google Scholar
52.La Via, MC, Gray, N, Kaye, WH. Case reports of olanzapine treatment of anorexia nervosa. Int J Eat Disord. 2000; 27(3): 363366.Google Scholar
53.Wang, TS, Chou, YH, Shiah, IS. Combined treatment of olanzapine and mirtazapine in anorexia nervosa associated with major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2006; 30(2): 306309.Google Scholar
54.Bosanac, P, Kurlender, S, Norman, T. An open-label study of quetiapine in anorexia nervosa. Hum Psychopharmacol. 2007; 22(4): 223230.Google Scholar
55.Powers, PS, Bannon, Y, Eubanks, R, McCormick, T. Quetiapine in anorexia nervosa patients: an open label outpatient pilot study. Int J Eat Disord. 2007; 40(1): 2126.Google Scholar
56.Trunko, ME, Schwartz, TA, Duvvuri, V, Kaye, WH. Aripiprazole in anorexia nervosa and low-weight bulimia nervosa: case reports. Int J Eat Disord. 2010; 44(3): 269275.Google Scholar
57.Barcai, A. Lithium in adult anorexia nervosa: a pilot report on two patients. Acta Psychiatr Scand. 1977; 55(Suppl 2): 97101.Google Scholar
58.Gross, HA, Ebert, MH, Faden, VB, Goldberg, SC, Nee, LE, Kaye, WH. A double-blind controlled trial of lithium carbonate primary anorexia nervosa. J Clin Psychopharmacol. 1981; 1(6): 376381.Google Scholar
59.Yung, CY. A review of clinical trials of lithium in medicine. Pharmacol Biochem Behav. 1984; 21(Suppl 1): 5155.Google Scholar
60.Casper, RC, Schlemmer, RF Jr, Javaid, JI. A placebo-controlled crossover study of oral clonidine in acute anorexia nervosa. Psychiatry Res. 1987; 20(Suppl 3): 249260.Google Scholar
61.Goldberg, SC, Halmi, KA, Eckert, ED, Casper, RC, Davis, JM. Cyproheptadine in anorexia nervosa. Br J Psychiatry. 1979; 134(1): 6770.Google Scholar
62.Walsh, BT. The future of research on eating disorders. Appetite. 2004; 42(1): 510.CrossRefGoogle ScholarPubMed
63.Schüle, C, Sighart, C, Hennig, J, Laakmann, G. Mirtazapine inhibits salivary cortisol concentrations in anorexia nervosa. Prog Neuropsychopharmacol Biol Psychiatry. 2006; 30(6): 10151019.Google Scholar
64.Yasuhara, D, Nakahara, T, Harada, T, Inui, A. Olanzapine-induced hyperglycemia in anorexia nervosa. Am J Psychiatry. 2007; 164(3): 528529.Google Scholar
65.Court, A, Mulder, C, Kerr, M, et al. Investigating the effectiveness, safety and tolerability of quetiapine in the treatment of anorexia nervosa in young people: a pilot study. J Psychiatr Res. 2010; 44(15): 10271034.Google Scholar
66.Delsedime, N, Nicotra, B, Giovannone, MC, et al. Psychotic symptoms in a woman with severe Anorexia Nervosa: psychotic symptoms in Anorexia Nervosa. Eat Weight Disord. 2013; 18(1): 9598.Google Scholar