Pharmacotherapy, alternative and adjunctive therapies for eating disorders: findings from a rapid review.
Adjunctive therapy
Alternative therapy
Anorexia nervosa
Binge eating disorder
Bulimia nervosa
Eating disorders
Pharmacotherapy
Journal
Journal of eating disorders
ISSN: 2050-2974
Titre abrégé: J Eat Disord
Pays: England
ID NLM: 101610672
Informations de publication
Date de publication:
06 Jul 2023
06 Jul 2023
Historique:
received:
02
12
2022
accepted:
20
06
2023
medline:
7
7
2023
pubmed:
7
7
2023
entrez:
6
7
2023
Statut:
epublish
Résumé
The current review broadly summarises the evidence base for pharmacotherapies and adjunctive and alternative therapies in the treatment of eating disorders and disordered eating. This paper forms part of a Rapid Review series examining the evidence base in the field of eating disorders. This was conducted to inform the Australian National Eating Disorder Research and Translation Strategy 2021-2030. ScienceDirect, PubMed and Ovid/Medline were searched for included studies published between 2009 and 2021 in English. High-level evidence such as meta-analyses, large population studies and randomised control trials were prioritised, and grey literature excluded. Data from included studies relating to pharmacotherapy, and to adjunctive and alternative therapies in eating disorders, were synthesised and disseminated in the current review. A total of 121 studies were identified, relating to pharmacotherapy (n = 90), adjunctive therapies (n = 21) and alternative therapies (n = 22). Some of the identified studies involved combinations of the above (e.g. adjunctive pharmacotherapy). Evidence of efficacy of interventions across all three categories was very limited with few relevant high quality clinical trials. There was a particular scarcity of evidence around effective treatments for anorexia nervosa (AN). With treatment of bulimia nervosa (BN), fluoxetine has exhibited some efficacy leading to regulatory approval in some countries. With binge eating disorder (BED), recent evidence supports the use of lisdexamfetamine. Neurostimulation interventions show some emerging efficacy in the treatment of AN, BN and BED but some, such as deep brain stimulation can be highly invasive. Despite widespread use of medications, this Rapid Review has identified a lack of effective medications and adjunctive and alternative therapies in the treatment of EDs. An intensification of high-quality clinical trial activity and drug discovery innovation are required to better assist patients suffering from EDs. Eating disorders have the highest mortality rates and treatment costs of all mental health conditions. This rapid review summarises the evidence around the use of medications and various alternative therapies in the treatment of eating disorders. The review highlights a lack of effective interventions for the treatment of anorexia nervosa with an urgent need to trial new treatments for this condition. Two medications show some efficacy in treating other eating disorders: the antidepressant drug fluoxetine for the treatment of bulimia nervosa, and the stimulant drug lisdexamfetamine for binge eating disorder. There is some positive evidence emerging from novel therapies that involve brain stimulation technologies. Overall, more high-quality research is needed to discover and develop new medications, and other alternative therapies, to better assist patients with eating disorders.
Sections du résumé
BACKGROUND
BACKGROUND
The current review broadly summarises the evidence base for pharmacotherapies and adjunctive and alternative therapies in the treatment of eating disorders and disordered eating.
METHODS
METHODS
This paper forms part of a Rapid Review series examining the evidence base in the field of eating disorders. This was conducted to inform the Australian National Eating Disorder Research and Translation Strategy 2021-2030. ScienceDirect, PubMed and Ovid/Medline were searched for included studies published between 2009 and 2021 in English. High-level evidence such as meta-analyses, large population studies and randomised control trials were prioritised, and grey literature excluded. Data from included studies relating to pharmacotherapy, and to adjunctive and alternative therapies in eating disorders, were synthesised and disseminated in the current review.
RESULTS
RESULTS
A total of 121 studies were identified, relating to pharmacotherapy (n = 90), adjunctive therapies (n = 21) and alternative therapies (n = 22). Some of the identified studies involved combinations of the above (e.g. adjunctive pharmacotherapy). Evidence of efficacy of interventions across all three categories was very limited with few relevant high quality clinical trials. There was a particular scarcity of evidence around effective treatments for anorexia nervosa (AN). With treatment of bulimia nervosa (BN), fluoxetine has exhibited some efficacy leading to regulatory approval in some countries. With binge eating disorder (BED), recent evidence supports the use of lisdexamfetamine. Neurostimulation interventions show some emerging efficacy in the treatment of AN, BN and BED but some, such as deep brain stimulation can be highly invasive.
CONCLUSION
CONCLUSIONS
Despite widespread use of medications, this Rapid Review has identified a lack of effective medications and adjunctive and alternative therapies in the treatment of EDs. An intensification of high-quality clinical trial activity and drug discovery innovation are required to better assist patients suffering from EDs.
Eating disorders have the highest mortality rates and treatment costs of all mental health conditions. This rapid review summarises the evidence around the use of medications and various alternative therapies in the treatment of eating disorders. The review highlights a lack of effective interventions for the treatment of anorexia nervosa with an urgent need to trial new treatments for this condition. Two medications show some efficacy in treating other eating disorders: the antidepressant drug fluoxetine for the treatment of bulimia nervosa, and the stimulant drug lisdexamfetamine for binge eating disorder. There is some positive evidence emerging from novel therapies that involve brain stimulation technologies. Overall, more high-quality research is needed to discover and develop new medications, and other alternative therapies, to better assist patients with eating disorders.
Autres résumés
Type: plain-language-summary
(eng)
Eating disorders have the highest mortality rates and treatment costs of all mental health conditions. This rapid review summarises the evidence around the use of medications and various alternative therapies in the treatment of eating disorders. The review highlights a lack of effective interventions for the treatment of anorexia nervosa with an urgent need to trial new treatments for this condition. Two medications show some efficacy in treating other eating disorders: the antidepressant drug fluoxetine for the treatment of bulimia nervosa, and the stimulant drug lisdexamfetamine for binge eating disorder. There is some positive evidence emerging from novel therapies that involve brain stimulation technologies. Overall, more high-quality research is needed to discover and develop new medications, and other alternative therapies, to better assist patients with eating disorders.
Identifiants
pubmed: 37415200
doi: 10.1186/s40337-023-00833-9
pii: 10.1186/s40337-023-00833-9
pmc: PMC10327007
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
112Investigateurs
Phillip Aouad
(P)
Sarah Barakat
(S)
Robert Boakes
(R)
Leah Brennan
(L)
Emma Bryant
(E)
Susan Byrne
(S)
Belinda Caldwell
(B)
Shannon Calvert
(S)
Bronny Carroll
(B)
David Castle
(D)
Ian Caterson
(I)
Belinda Chelius
(B)
Lyn Chiem
(L)
Simon Clarke
(S)
Janet Conti
(J)
Lexi Crouch
(L)
Genevieve Dammery
(G)
Natasha Dzajkovski
(N)
Jasmine Fardouly
(J)
John Feneley
(J)
Amber-Marie Firriolo
(AM)
Nasim Foroughi
(N)
Mathew Fuller-Tyszkiewicz
(M)
Anthea Fursland
(A)
Veronica Gonzalez-Arce
(V)
Bethanie Gouldthorp
(B)
Kelly Griffin
(K)
Scott Griffiths
(S)
Ashlea Hambleton
(A)
Amy Hannigan
(A)
Mel Hart
(M)
Susan Hart
(S)
Phillipa Hay
(P)
Ian Hickie
(I)
Francis Kay-Lambkin
(F)
Ross King
(R)
Michael Kohn
(M)
Eyza Koreshe
(E)
Isabel Krug
(I)
Jake Linardon
(J)
Randall Long
(R)
Amanda Long
(A)
Sloane Madden
(S)
Sarah Maguire
(S)
Danielle Maloney
(D)
Peta Marks
(P)
Sian McLean
(S)
Thy Meddick
(T)
Jane Miskovic-Wheatley
(J)
Deborah Mitchison
(D)
Richard O'Kearney
(R)
Shu Hwa Ong
(S)
Roger Paterson
(R)
Susan Paxton
(S)
Melissa Pehlivan
(M)
Genevieve Pepin
(G)
Andrea Phillipou
(A)
Judith Piccone
(J)
Rebecca Pinkus
(R)
Bronwyn Raykos
(B)
Paul Rhodes
(P)
Elizabeth Rieger
(E)
Sarah-Catherine Rodan
(SC)
Janice Russell
(J)
Haley Russell
(H)
Fiona Salter
(F)
Susan Sawyer
(S)
Beth Shelton
(B)
Urvashnee Singh
(U)
Sophie Smith
(S)
Evelyn Smith
(E)
Karen Spielman
(K)
Sarah Squire
(S)
Juliette Thomson
(J)
Stephen Touyz
(S)
Ranjani Utpala
(R)
Lenny Vartanian
(L)
Sabina Vatter
(S)
Andrew Wallis
(A)
Warren Ward
(W)
Sarah Wells
(S)
Eleanor Wertheim
(E)
Simon Wilksch
(S)
Michelle Williams
(M)
Informations de copyright
© 2023. The Author(s).
Références
BMJ Clin Evid. 2010 Jul 19;2010:
pubmed: 21418667
Int J Eat Disord. 2019 Jul;52(7):786-794
pubmed: 30938842
J Am Acad Child Adolesc Psychiatry. 2011 Sep;50(9):915-24
pubmed: 21871373
Int J Eat Disord. 2013 Apr;46(3):239-45
pubmed: 23381803
J Clin Psychiatry. 2013 Aug;74(8):e765-71
pubmed: 24021517
Clin Ther. 2021 Jan;43(1):17-39
pubmed: 33342555
Neuropsychopharmacology. 2016 Apr;41(5):1251-60
pubmed: 26346638
Psychopharmacology (Berl). 2012 Dec;224(4):501-9
pubmed: 22752384
J Consult Clin Psychol. 2019 Jan;87(1):91-105
pubmed: 30570304
Aust N Z J Psychiatry. 2009 Mar;43(3):227-34
pubmed: 19221911
J Adolesc Health. 2015 Jul;57(1):66-72
pubmed: 26095410
JAMA Psychiatry. 2017 Sep 1;74(9):903-910
pubmed: 28700805
Neuroimage Clin. 2015 Mar 24;8:1-31
pubmed: 26110109
J Psychiatr Res. 2005 May;39(3):303-10
pubmed: 15725429
Hum Psychopharmacol. 2016 Sep;31(5):382-91
pubmed: 27650406
Eat Disord. 2017 Jan-Feb;25(1):37-51
pubmed: 27723416
Expert Opin Pharmacother. 2019 Apr;20(6):679-690
pubmed: 30696303
J Diet Suppl. 2017 Mar 4;14(2):191-199
pubmed: 27835050
Eur Child Adolesc Psychiatry. 2003;12 Suppl 1:I20-4
pubmed: 12567211
J Child Adolesc Psychopharmacol. 2011 Jun;21(3):213-20
pubmed: 21510781
Psychiatr Clin North Am. 2011 Dec;34(4):785-96
pubmed: 22098804
PLoS Med. 2009 Jul 21;6(7):e1000097
pubmed: 19621072
Int J Clin Pract. 2015 Apr;69(4):410-21
pubmed: 25752762
Eat Weight Disord. 2011 Sep;16(3):e177-81
pubmed: 22290033
J Clin Psychopharmacol. 2012 Jun;32(3):341-5
pubmed: 22544016
Rev Colomb Psiquiatr (Engl Ed). 2021 Jan 19;:
pubmed: 33735059
Int J Eat Disord. 2004 Jan;35(1):10-5
pubmed: 14705152
J Neuroendocrinol. 2017 Mar;29(3):
pubmed: 28140486
Surg Neurol Int. 2021 Apr 19;12:169
pubmed: 34084597
Behav Res Ther. 2014 Nov;62:47-59
pubmed: 25151600
Adv Ther. 2017 Oct;34(10):2307-2315
pubmed: 28918581
Obes Res Clin Pract. 2015 May-Jun;9(3):301-4
pubmed: 25870084
Expert Opin Emerg Drugs. 2014 Mar;19(1):99-142
pubmed: 24460483
Brain Stimul. 2020 May - Jun;13(3):643-649
pubmed: 32289691
Life Sci. 2017 Jun 1;178:87-93
pubmed: 28438641
Int J Eat Disord. 2017 Apr;50(4):447-450
pubmed: 28334444
Am J Psychiatry. 2008 Oct;165(10):1281-8
pubmed: 18558642
Eur Eat Disord Rev. 2010 Jan;18(1):10-21
pubmed: 20054875
Eur Eat Disord Rev. 2020 Nov;28(6):739-749
pubmed: 32926514
Int J Eat Disord. 2011 Sep;44(6):515-23
pubmed: 20957705
Psychol Med. 2010 Jun;40(6):999-1005
pubmed: 20441691
Biol Psychiatry. 2001 Apr 1;49(7):644-52
pubmed: 11297722
Eat Disord. 2022 Jan-Feb;30(1):26-53
pubmed: 32991247
J Consult Clin Psychol. 2012 Dec;80(6):1108-13
pubmed: 22985205
Eur Neuropsychopharmacol. 2002 Oct;12(5):453-9
pubmed: 12208563
Psychoneuroendocrinology. 2020 Feb;112:104485
pubmed: 31805456
Int J Eat Disord. 2011 Jan;44(1):81-90
pubmed: 21080416
J Clin Psychopharmacol. 2017 Jun;37(3):315-322
pubmed: 28383364
Int J Eat Disord. 2016 Oct;49(10):930-936
pubmed: 27159906
CNS Spectr. 2021 Oct;26(5):481-490
pubmed: 32423512
Int J Eat Disord. 2021 May;54(5):872-878
pubmed: 33534199
Eur Eat Disord Rev. 2016 Nov;24(6):474-481
pubmed: 27633286
J Clin Sleep Med. 2021 Jul 1;17(7):1475-1483
pubmed: 33704048
Int Clin Psychopharmacol. 2007 Jul;22(4):197-204
pubmed: 17519642
Int J Eat Disord. 2013 Sep;46(6):553-9
pubmed: 23436476
Eat Weight Disord. 2021 Mar;26(2):407-415
pubmed: 32240516
Curr Neuropharmacol. 2018;16(8):1174-1192
pubmed: 29308739
Prostaglandins Other Lipid Mediat. 2017 Nov;133:11-19
pubmed: 28873340
CNS Spectr. 2021 Oct;26(5):459-467
pubmed: 32641176
Psychoneuroendocrinology. 2018 Jan;87:83-92
pubmed: 29049935
Lancet. 2013 Apr 20;381(9875):1361-1370
pubmed: 23473846
Int J Yoga. 2018 May-Aug;11(2):166-169
pubmed: 29755227
Eat Behav. 2016 Apr;21:179-88
pubmed: 26970732
Lancet Psychiatry. 2017 Apr;4(4):285-294
pubmed: 28238701
Ann Intern Med. 2016 Sep 20;165(6):409-20
pubmed: 27367316
Neuroimage Clin. 2015 Jul 02;8:611-8
pubmed: 26199873
Int J Eat Disord. 2013 May;46(4):332-9
pubmed: 23001863
BMC Psychiatry. 2018 Apr 10;18(1):93
pubmed: 29631553
Psychol Med. 2011 Oct;41(10):2177-82
pubmed: 21426603
J Clin Epidemiol. 2021 Jan;129:74-85
pubmed: 33038541
Eat Weight Disord. 2015 Mar;20(1):13-21
pubmed: 24890912
CNS Spectr. 2016 Apr;21(2):134-42
pubmed: 26145463
Expert Opin Drug Saf. 2018 Jan;17(1):17-23
pubmed: 29053927
Eur Eat Disord Rev. 2013 Sep;21(5):361-73
pubmed: 23733453
J Clin Psychiatry. 2013 Apr;74(4):400-6
pubmed: 23656848
JAMA Psychiatry. 2015 Mar;72(3):235-46
pubmed: 25587645
Pharmacol Ther. 2021 Jan;217:107667
pubmed: 32858054
Appetite. 2015 Jun;89:136-44
pubmed: 25660340
Complement Ther Med. 2009 Aug;17(4):196-202
pubmed: 19632546
Psychiatry Res. 2019 Mar;273:467-474
pubmed: 30684794
Physiotherapy. 2013 Mar;99(1):1-11
pubmed: 23219634
Int J Neuropsychopharmacol. 2012 Mar;15(2):209-22
pubmed: 21439105
J Clin Psychiatry. 2019 Feb 26;80(2):
pubmed: 30817099
J Eat Disord. 2016 Dec 9;4:38
pubmed: 27980773
Eat Weight Disord. 2015 Sep;20(3):319-27
pubmed: 25694219
JAMA. 2006 Jun 14;295(22):2605-12
pubmed: 16772623
J Consult Clin Psychol. 2015 Apr;83(2):387-94
pubmed: 25622201
J Clin Psychiatry. 2018 Jan/Feb;79(1):
pubmed: 29325236
Int J Neuropsychopharmacol. 2012 Mar;15(2):189-207
pubmed: 21414249
J Clin Psychiatry. 2003 Nov;64(11):1335-41
pubmed: 14658948
Evid Based Ment Health. 2019 May;22(2):77-82
pubmed: 31003978
Curr Psychiatry Rep. 2015 May;17(5):35
pubmed: 25796197
PLoS One. 2016 Mar 23;11(3):e0148606
pubmed: 27008620
Expert Opin Drug Metab Toxicol. 2018 Feb;14(2):229-238
pubmed: 29258368
Int J Eat Disord. 2014 Jan;47(1):18-23
pubmed: 24105610
Clin Drug Investig. 2016 Apr;36(4):305-12
pubmed: 26914658
J Adolesc Health. 2010 Apr;46(4):346-51
pubmed: 20307823
Int J Eat Disord. 2018 Feb;51(2):139-145
pubmed: 29215743
Int J Eat Disord. 2017 Aug;50(8):884-892
pubmed: 28481434
Eat Behav. 2013 Apr;14(2):199-203
pubmed: 23557820
J Clin Psychiatry. 2003 Dec;64(12):1449-54
pubmed: 14728106
J Clin Psychiatry. 2020 Sep 8;81(5):
pubmed: 32926604
Clin Psychol Rev. 2012 Feb;32(1):49-59
pubmed: 22142838
Eur Psychiatry. 2015 Nov;30(8):924-31
pubmed: 26647868
PLoS One. 2017 Jan 25;12(1):e0167606
pubmed: 28121991
J Eat Disord. 2022 Mar 4;10(1):31
pubmed: 35246250
Clin Psychol Rev. 2016 Feb;43:175-92
pubmed: 26781985
Int J Eat Disord. 2018 Dec;51(12):1367-1372
pubmed: 30367519
Eat Weight Disord. 2016 Sep;21(3):395-402
pubmed: 26830430
Physiol Behav. 2012 May 15;106(2):238-42
pubmed: 22361261
Psychiatry Res. 2018 Nov;269:145-156
pubmed: 30149272
Int Clin Psychopharmacol. 2015 Jul;30(4):209-15
pubmed: 26011779
Appetite. 2018 May 1;124:78-88
pubmed: 28288802
Eur Eat Disord Rev. 2012 Jul;20(4):331-4
pubmed: 22535517
Expert Rev Clin Pharmacol. 2018 Jan;11(1):95-108
pubmed: 28933969
Australas Psychiatry. 2005 Mar;13(1):72-5
pubmed: 15777417
Int J Eat Disord. 2016 May;49(5):473-81
pubmed: 26691428
J Psychosom Res. 2013 Jul;75(1):36-42
pubmed: 23751236
Psychiatry Res Neuroimaging. 2019 Apr 30;286:53-59
pubmed: 30903953
Eur Eat Disord Rev. 2013 Nov;21(6):475-8
pubmed: 24115458
BMJ Open. 2018 Jul 16;8(7):e021531
pubmed: 30012789
Med Clin (Barc). 2014 Sep 9;143(5):196-200
pubmed: 24035412
Int J Eat Disord. 2013 Jul;46(5):470-7
pubmed: 23658094
Complement Ther Med. 2019 Oct;46:73-80
pubmed: 31519291
Medwave. 2017 Dec 1;17(9):e7095
pubmed: 29194432
Lancet. 2020 Mar 14;395(10227):912-920
pubmed: 32112714
Exp Clin Endocrinol Diabetes. 2013 Jan;121(1):20-6
pubmed: 23147209
Psychoneuroendocrinology. 2014 Jun;44:133-42
pubmed: 24703429
PLoS One. 2015 Sep 24;10(9):e0137514
pubmed: 26402337
PLoS One. 2015 Apr 29;10(4):e0125569
pubmed: 25922939
Eur Eat Disord Rev. 2017 Mar;25(2):67-79
pubmed: 27928853
Clin Ther. 2021 Jan;43(1):112-122.e1
pubmed: 33218742
Int J Neuropsychopharmacol. 2011 May;14(4):553-66
pubmed: 20860875
J Psychiatr Res. 2010 Nov;44(15):1027-34
pubmed: 20447652
Physiol Behav. 2015 Dec 1;152(Pt B):456-65
pubmed: 26057573
Curr Psychiatry Rep. 2016 Jun;18(6):55
pubmed: 27086316
Am J Psychiatry. 2019 Jun 1;176(6):449-456
pubmed: 30654643
Child Adolesc Psychiatr Clin N Am. 2019 Oct;28(4):583-592
pubmed: 31443877
Eat Weight Disord. 2013 Mar;18(1):3-9
pubmed: 23757245