Psychotropic medication use in anorexia nervosa between 1997 and 2009

Abstract

Objective Despite a lack of data demonstrating benefit, psychotropic medications are frequently prescribed for patients with anorexia nervosa. Method We studied 525 women (18–54 years of age) with anorexia nervosa who presented to the Clinical Research Center at the Massachusetts General Hospital between January 1997–December 2009. For this analysis, participants were a priori divided into two groups based on date of presentation (group I: participants presenting between 1997–2002; group II: participants presenting between 2003–2009). Results Overall, 53% of participants reported current use of any psychotropic medication; 48.4% reported use of an antidepressant and 13% reported use of an antipsychotic. Twice as many participants in group II (18.5%) reported using atypical antipsychotics as compared to group I (8.9%) (p=0.002). Discussion A majority of participants with anorexia nervosa report using psychotropic medications despite lack of data supporting their efficacy. These data are concerning given the known adverse effects of these medications.

Second Generation Antipsychotics in Adolescent Anorexia Nervosa: A New Hypothesis of Eligibility Criteria

“…This conclusion is intriguing, because it shows how difficult it could be to identify the patients eligible for drug treatment. Our hypothesis is driven by Norris's work, by the discrepancies between research results (Kishi et al 2012;Lebow et al 2013) and clinical practice (Fazeli et al 2012), and by our set of data (although limited by the small sample size) and other openlabel studies. We hypothesize some strict criteria for considering AN adolescent patients eligible for SGA treatment.…”

“…Moreover, SGA use fits well with some neurobiological models of AN, focusing on monoamine dysfunction (Kishi et al 2012). It is particularly challenging to understand why SGA are being more and more used (Fazeli et al 2012), given their side effects, such as metabolic and hormonal disturbances, extrapyramidal side effects (EPS), somnolence, and hypotension, all occurring mainly at beginning of treatment, and potentially threatening the therapeutic alliance. In this article, we will present clinical data from a set of AN adolescents, followed up naturalistically for at least 6 months, who were much improved after adding olanzapine to usual clinical management.…”

The Role and Basis of Neuroleptics in the Treatment of Anorexia Nervosa

“…Ir nors rekomendacijų skirti atipinius antipsichotikus nei šiose, nei NICE gairėse nėra, šių medikamentų skyrimas, ypač olanzapino, NA sergančioms pacientėms didėja, yra duomenų, kad JAV iki 18,5 proc. pacientų buvo gydoma atipiniais antipsichotikais, o jų skaičius, lyginant 1997-2002 ir 2003-2009 metų periodus, padvigubėjo [4,5].…”

Anorexia Nervosa and Antipsychotics: How to Apply Research Findings to the Adolescent Population

“…Many individuals with AN experience mood and anxiety disorder symptoms (Hudson et al, 2007) and antidepressants are often prescribed for patients with AN (Fazeli et al, 2012;Rosen, 2010). Physicians treating AN have at times placed the disorder on the anxiety or mood spectrum and attempted to restart eating by first improving co-morbid disorders such as obsessivecompulsive disorder or major depressive disorder.…”