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MEDICATIONS IN THE TREATMENT OF EATING DISORDERS

1996; Elsevier BV; Volume: 19; Issue: 4 Linguagem: Inglês

10.1016/s0193-953x(05)70378-6

1558-3147

David C. Jimerson, Barbara E. Wolfe, Andrew W. Brotman, Eran D. Metzger,

Pharmacology and Obesity Treatment

This article provides an overview of current psychopharmacologic research on treatment approaches in patients with bulimia nervosa and anorexia nervosa. For bulimia nervosa, in particular, the role of medication treatment has expanded substantially over the past 15 years with publication of double-blind, placebo-controlled trials demonstrating significant response to antidepressant medications. Therapeutic planning for the individual patient depends on the clinician's broad familiarity with the assessment, diagnosis, epidemiology, psychotherapeutic interventions, physiologic concomitants, and natural history of these disorders.4 Before prescribing medication for a patient with an eating disorder, the clinician should consult the manufacturer's guidelines for use of the specific agent. Risk factors for the onset and persistence of eating-disorder symptomatology are likely to reflect biologic as well as psychosocial dimensions. Increased understanding of psychobiologic dimensions of these disorders is likely to result in improved pharmacologic treatment approaches in the future. Biologic influences may contribute to such changes as mood dysregulation or increased impulsivity, or may exert diverse effects on patterns of eating behavior per se. Heuristic models have been developed for studying psychobiologic influences on eating behavior.11, 12 Increasingly selective pharmacologic treatments may mitigate eating-disorder symptomatology through modulation of hunger, satiety, food reward, or metabolic signals. Examples of endogenous neurotransmitters and related neurochemicals involved in the regulation of these processes are as follows: Hunger signals Norepinephrine Neuropeptide Y Food reward signals Dopamine Endogenous opiates Satiety signals Serotonin Cholecystokinin Metabolic signals Leptin This list of neurochemical signals is intended to be illustrative rather than comprehensive.