Use of Fluoxetine in Anorexia Nervosa Before and After Weight Restoration

Sebaaly, Jamielynn; Cox, Stéphanie; Hughes, C. M.; Kennedy, Mark; Garris, Shauna S.

doi:10.1177/1060028013503127

Cited by 19 publications

(9 citation statements)

References 11 publications

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“…Another line of evolving research suggests that olanzapine, an atypical antipsychotic, may also have merit as an adjunctive medication for patients with AN, with reported improvements in weight gain, anxiety and body image, although few adolescent-specific studies have been conducted to date [ 9 – 13 ]. To a similar degree, some conflicting research has shown that the use of fluoxetine, a selective serotonin reuptake inhibitor (SSRI), may reduce co-morbid symptoms of depression, anxiety, and obsessive compulsive disorder for weight-restored adult AN patients [ 14 – 16 ]. SSRIs are indicated for the treatment of anxiety and depression in adolescents without eating disorders [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment of children and adolescents with avoidant/restrictive food intake disorder: a case series examining the feasibility of family therapy and adjunctive treatments

et al. 2018

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BackgroundTo date, little research has examined the effectiveness of either modified Family-Based Therapy or psychopharmacological treatments for patients diagnosed with avoidant/restrictive food intake disorder (ARFID), and there is little evidence to guide clinicians treating children and adolescents with ARFID. This case series describes the clinical presentations, treatments and outcomes of six patient diagnosed with ARFID who were treated sequentially by a child psychiatrist and adolescent medicine physician in a hospital-based eating disorder program. Case PresentationsFive out of six cases were female and median age of patients at assessment was 12.9 (SD = 1.13) years. On average, patients’ percentage of treatment goal weight was 80.5% at initial assessment (SD = 8.56) and 81.9% (SD = 7.08) when family therapy began. Cases 1, 2 and 3 were admitted to a specialized inpatient unit at assessment due to medical instability (2) or failed outpatient treatment (1), and all six cases presented with severe co-morbid anxiety. All patients were treated using a combination of medical monitoring, family therapy, medication (including olanzapine, fluoxetine and in two cases cyproheptadine), and cognitive behavioural therapy. At treatment termination, all six patients had achieved their goal weight.ConclusionThese cases illustrate the complex ways in which young patients with ARFID can present, the illness’ effect on development and mental health, and the positive outcomes associated with weight gain and concurrent treatment for co-morbid anxiety disorders.

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Section: Introductionmentioning

confidence: 99%

Treatment of children and adolescents with avoidant/restrictive food intake disorder: a case series examining the feasibility of family therapy and adjunctive treatments

et al. 2018

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“…However, to date no clinical trials have defined the riskbenefit ratio of fluoxetine pharmacotherapy in patients with AN, so practice relies still on clinical judgment (Sebaaly et al 2013). Treatment response may be moderated by weight restoration status, which was a factor in V.'s fluoxetine initiation in week 13 of her 16 week inpatient hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Pharmacotherapeutic Considerations in the Treatment of an Adolescent with Anorexia Nervosa and Obsessive Compulsive Disorder

Rice

Coffey

2015

Journal of Child and Adolescent Psychopharmacology

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“…Among the 45 reviews or meta-analyses, 26 were excluded for the following reasons: 16 were overviews and/or not systematic reviews with no explicit methodology for the selection of the papers mentioned [9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24], one review [25] predated the World Federation of Societies of Biological Psychiatry review, one [26] reviewed the same eight studies as a meta-analysis included [27], five focused on unpublished data, or studies that were reviewed in later papers included here [28,29,30,31,32], one mainly focused on emerging treatment research or perspectives [33], two concerned oxytocin but with no specific results in AN [34,35].…”

Section: Methodsmentioning

confidence: 99%

Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews

Blanchet

Guillaume

Bat-Pitault

et al. 2019

JCM

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Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication (psychotropic drugs and medication for somatic and nutritional complications) in the field of anorexia nervosa since the 1960s, (2) to draw practical conclusions for everyday practise and future research. Searches were performed on three online databases, namely MEDLINE, Epistemonikos and Web of Science. Papers published between September 2011 and January 2019 were considered. Evidence-based data were identified from meta-analyses, if there were none, from systematic reviews, and otherwise from trials (randomized or if not open-label studies). Evidence-based results are scarce. No psychotropic medication has proved efficacious in terms of weight gain, and there is only weak data suggesting it can alleviate certain psychiatric symptoms. Concerning nutritional and somatic conditions, while there is no specific, approved medication, it seems essential not to neglect the interest of innovative therapeutic strategies to treat multi-organic comorbidities. In the final section we discuss how to use these medications in the overall approach to the treatment of anorexia nervosa.

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Use of Fluoxetine in Anorexia Nervosa Before and After Weight Restoration

Abstract: The risk-benefit ratio of fluoxetine in underweight and weight-restored patients with AN is undefined by clinical trials; therefore, clinical experience must be applied for its use in this patient population.

Cited by 19 publications

References 11 publications

Treatment of children and adolescents with avoidant/restrictive food intake disorder: a case series examining the feasibility of family therapy and adjunctive treatments

Treatment of children and adolescents with avoidant/restrictive food intake disorder: a case series examining the feasibility of family therapy and adjunctive treatments

Pharmacotherapeutic Considerations in the Treatment of an Adolescent with Anorexia Nervosa and Obsessive Compulsive Disorder

Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews

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