Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition and physical health consequences.
Antipsychotic Agents
/ administration & dosage
Avitaminosis
Clinical Decision-Making
/ methods
Drug Monitoring
/ methods
Feeding and Eating Disorders
/ drug therapy
Humans
Malnutrition
/ drug therapy
Mental Disorders
/ drug therapy
Patient Care Planning
Pharmacogenomic Testing
/ methods
Sleep Wake Disorders
/ drug therapy
Trace Elements
/ deficiency
Water-Electrolyte Balance
/ physiology
Anorexia nervosa
Antidepressants
Anxiety
Benzodiazepines
Binge eating disorder
Bipolar disorder
Bulimia nervosa
Depression
Electrolytes vitamins
Fluoxetine
Gastroprokinetic drugs
Laxatives
Lisdexamfetamine
Obesity
Osteoporosis
Promethazine
Reflux
Sleep problems
Zopiclone
insulin, and paracetamol
proton-pump inhibitors
suicidality
Journal
Pharmacology & therapeutics
ISSN: 1879-016X
Titre abrégé: Pharmacol Ther
Pays: England
ID NLM: 7905840
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
03
01
2020
accepted:
17
08
2020
pubmed:
29
8
2020
medline:
16
11
2021
entrez:
29
8
2020
Statut:
ppublish
Résumé
The pharmacological treatment of patients with an eating disorder (ED) often includes medications to treat their ED, comorbid mental health problems, malnutrition and the physical health problems resulting from it. The currently approved pharmacological treatment options for EDs are limited to fluoxetine for bulimia nervosa (BN) and - in some countries - lisdexamfetamine for binge eating disorder (BED). Thus, there are no approved pharmacological options for anorexia nervosa (AN), even though study results for olanzapine and dronabinol are promising. Topiramate might be an additional future option for the treatment of BN and BED. Selective serotonin reuptake inhibitors (SSRI), mirtazapine and bupropion could be considered for the treatment of comorbid unipolar depression. However, AN and BN are contraindications for bupropion. For ED patients with a manic episode, we recommend olanzapine in AN and risperidone in BN and BED; whereas for bipolar depression, olanzapine (plus fluoxetine) seems appropriate in AN and lamotrigine in BN and BED. Acute anxiety or suicidality may warrant benzodiazepine treatment with lorazepam. Proton-pump inhibitors, gastroprokinetic drugs, laxatives and hormones can alleviate certain physical health problems caused by EDs. Therapeutic drug monitoring, pharmacogenomic testing, a more restrictive use of "pro re nata" (PRN) medication, an interdisciplinary treatment approach, shared decision making (SDM) and the formulation of common treatment goals by the patients, their family or carers and clinicians could improve treatment success and safety. Novel genetic, immunological, microbiome and brain imaging research as well as new pharmacological developments like the use of psychedelics, stimulants, novel monoaminergic drugs, hormone analogues and drugs which enhance the effects of psychotherapy may extend our therapeutic options in the near future.
Identifiants
pubmed: 32858054
pii: S0163-7258(20)30197-2
doi: 10.1016/j.pharmthera.2020.107667
pii:
doi:
Substances chimiques
Antipsychotic Agents
0
Trace Elements
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
107667Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no conflict of interest.