World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Eating Disorders

Abstract

Additional research is needed for the improvement of the treatment of eating disorders. Especially for anorexia nervosa there is a need for further pharmacological treatment strategies.

The Combination of Levomilnacipran, Cognitive Behavior Therapy and Christian Based Self –Help Group in the Treatment of Bulimia Nervosa: A Case Report

“…The MAOIs antidepressants such as phenelzine which seemed to be beneficial in BN treatment its required dietary restrictions and its interactions with a wide variety of non-prescription medications usually used by BN patients make this class less appropriate for treatment of this condition [10]. Other antidepressant such as trazodone and mirtazapine, and mood stabilizers such as, topiramate, lithium ,valproic acid have also been used with some effectiveness in BN [6][7][8][12][13][14]. Other agents including odansetron, d-fenfluramine, baclofen, orlistat, antiandrogenic oral contraceptive, human growth hormone, cannabis, zinc, clonidine, antihistaminics, prokinetic agents, methylphenidate, the atypical or second generation antipsychotics such as olanzapine and aripipriazole, have been also used as alternative options in the management of BN all with limited beneficial effects [12][13][14][15][16][17][18].…”

“…Among the SSRIs fluoxetine is the only pharmacological agent that has been approved in the US by the Food and Drug Administration (FDA) for the treatment of BN [7]. Fluoxetine (Prozac®) has shown beneficial clinical effects in decreasing the binging and purging cycle, and in preventing relapse [8]. Clinicians have used other agents beside the SSRIs, including serotonin norepinephrine reuptake inhibitors (SNRIs), various tricyclic antidepressants (TCAs), mirtazapine, antiepileptic such as topiramate and the antiemetic ondansetron [6][7][8].…”

“…Fluoxetine (Prozac®) has shown beneficial clinical effects in decreasing the binging and purging cycle, and in preventing relapse [8]. Clinicians have used other agents beside the SSRIs, including serotonin norepinephrine reuptake inhibitors (SNRIs), various tricyclic antidepressants (TCAs), mirtazapine, antiepileptic such as topiramate and the antiemetic ondansetron [6][7][8]. Despite its possible effectiveness, the antidepressant bupropion is contraindicated because of the association of its use with seizures in patients who purge and its anorexic side effects [9].…”

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

“…Pasaulio biologinės psichiatrijos draugijų federacijos (WFSBP) NA farmakologinio gydymo gairėse nurodoma, jog patikimų kontroliuojamųjų tyrimų įrodymų nėra, pateikiami nustatyti riboti teigiami kontroliuojamųjų tyrimų įrodymai cinko papildams, o išsekusioms NA sergančioms pacientėms gali būti tikslinga skirti maitinimą per nazogastrinį zondą [3]. 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.…”

Erratum: Effects of the mu-opioid receptor antagonist GSK1521498 on hedonic and consummatory eating behaviour: a proof of mechanism study in binge-eating obese subjects

“…11,18 Positive therapeutic effects on both weight and binge eating have been reported with topiramate (antiepileptic), atomoxetine (norepinephrine reuptake inhibitor), sibutramine (mixed monoamine reuptake inhibitor causing anorexia and thermogenesis), the stimulant phentermine, selective serotonin reuptake inhibitors and rimonabant (cannabinoid receptor 1 inverse agonist). [19][20][21][22][23][24][25] However, safety concerns regarding psychiatric (rimonabant, topiramate) and cardiovascular risks (sibutramine, atomoxetine, phentermine) have hindered the clinical deployment of these treatments [26].…”