This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rossi, G. Articles by Lanzi, G. Search for Related Content PubMed PubMed Citation Articles by Rossi, G. Articles by Lanzi, G. Pubmed/NCBI databases Medline Plus Health Information Antidepressants Eating Disorders Social Bookmarking                         What's this?

Pharmacological Treatment of Anorexia Nervosa: A Retrospective Study in Preadolescents and Adolescents

Department of Child Neurology and Psychiatry, IRCCS C. Mondino Foundation, University of Pavia, Pavia, Italy, giorossi{at}unipv.it

U. Balottin

Child Neuropsychiatry Unit, Department of Clinical and Biological Sciences, University of Insubria, Macchi Foundation Hospital, Varese, Italy

M. Rossi

Department of Child Neurology and Psychiatry, IRCCS C. Mondino Foundation, University of Pavia, Pavia, Italy

M. Chiappedi

Department of Child Neurology and Psychiatry, IRCCS C. Mondino Foundation, University of Pavia, Pavia, Italy, Child Neuropsychiatry and Rehabilitation Unit, Medical Center Santa Maria alle Fonti, Don Carlo Gnocchi Foundation, Salice Terme, Pavia, Italy

E. Fazzi

Department of Child Neurology and Psychiatry, IRCCS C. Mondino Foundation, University of Pavia, Pavia, Italy

G. Lanzi

Department of Child Neurology and Psychiatry, IRCCS C. Mondino Foundation, University of Pavia, Pavia, Italy

To date, studies addressing the role of pharmacotherapy in the treatment of anorexia nervosa are limited, especially in childhood and adolescence. The aim of this retrospective naturalistic study was to evaluate the efficacy and safety of pharmacotherapy in 19 anorexic preadolescents and adolescents referred, for the first time, to a specialist psychiatry unit. Almost all the patients showed an improvement both in their eating behaviors, and in their mood and obsessive symptoms. No evidence was found of dangerous adverse events. Combined with a multidisciplinary approach that includes nutritional rehabilitation and psychotherapy, adjunctive pharmacotherapy may be useful in addressing both eating disorder psychopathology and comorbid psychiatric disorders.

Key Words: anorexia nervosa • pharmacotherapy • adolescence

References

• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed revised. Washington, DC: American Psychiatric Association; 2002.
• Sullivan PF Mortality in anorexia nervosa. Am J Psychiatry. 1995;152:1073-1074.[Abstract/Free Full Text]
• Keel PK, Dorer DJ, Eddy KT, et al. Predictors of mortality in eating disorders. Arch Gen Psychiatry. 2003; 60:179-183.[Abstract/Free Full Text]
• Stunkard A. Eating disorders: the last 25 years. Appetite. 1997;29:181-190.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Steinhausen HC The outcome of anorexia nervosa in the 20th century. Am J Psychiatry. 2002;159:1284-1293.[Abstract/Free Full Text]
• Powers PS, Santana C. Available pharmacological treatments for anorexia nervosa. Expert Opin Pharmacother. 2004;5:2287-2292.
• Israel M. What is the role of pharmacotherapy in the treatment of anorexia nervosa? J Psychiatry Neurosci. 2005;30:464.[Web of Science][Medline] [Order article via Infotrieve]
• Attia E., Schroeder L. Pharmacological treatment of anorexia nervosa: where do we go from here? Int J Eat Disord. 2005;37Suppl:S60-63; discussion S87-89.[CrossRef][Web of Science]
• Holtkamp K., Konrad K., Kaiser N., et al. A retrospective study of SSRI treatment in adolescent anorexia nervosa: insufficient evidence for efficacy. J Psychiatr Res. 2005; 39:303-310.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Guy W. ECDEU Assessment Manual for Psychopharmacology. Revised. Rockville, MD: National Institute of Mental Health; 1976.
• Schimmelmann BG, Paulus S., Schacht M., et al. Subjective distress related to side effects and subjective well-being in first admitted adolescents with early-onset psychosis treated with atypical antipsychotics. J Child Adolesc Psychopharmacol. 2005; 15:249-258.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Pavuluri MN, Henry DB, Carbray JA, et al. Divalproex sodium for pediatric mixed mania: a 6-month prospective trial. Bipolar Disord. 2005;7:266-273.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Schooler N., Rabinowitz J., Davidson M., et al. Risperidone and haloperidol in first-episode psychosis: a long-term randomized trial. Am J Psychiatry. 2005;162: 947-953.[Abstract/Free Full Text]
• Kapur S., Arenovich T., Agid O., et al. Evidence for onset of antipsychotic effects within the first 24 hours of treatment. Am J Psychiatry. 2005;162:939-946.[Abstract/Free Full Text]
• Kaye WH, Weltzin TE, Hsu G., et al. An open trial of fluoxetine in patients with anorexia nervosa. J Clin Psychiatry. 1991;52:464-471.[Web of Science][Medline] [Order article via Infotrieve]
• Kaye WH, Weltzin TE, Hsu G., et al. Relapse Prevention With Fluoxetine in Anorexia Nervosa: A Double-Blind Placebo-controlled Study. Washington, DC: American Psychiatric Association; 1997:178.
• Godart NT, Perdereau F., Jeammet P., Flament MF Comorbidity between eating disorders and mood disorders: review. Encephale. 2005;31(5 Pt1):575-587.[Web of Science][Medline] [Order article via Infotrieve]
• Pollice C., Kaye WH, Greeno CG, et al. Relationship of depression, anxiety, and obsessionality to state of illness in anorexia nervosa. Int J Eat Disord. 1997;21:367-376.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Lacey JH, Crisp AH Hunger, food intake and weight: the impact of clomipramine on a refeeding anorexia nervosa population. Postgrad Med J. 1980;56(Suppl 1):79-85.[Web of Science][Medline] [Order article via Infotrieve]
• Biederman J., Herzog DB, Rivinus TM, et al. Amitriptyline in the treatment of anorexia nervosa: a double-blind, placebo-controlled study. J Clin Psychopharmacol. 1985; 5:10-16.[Web of Science][Medline] [Order article via Infotrieve]
• Halmi KA, Eckert ED, LaDu TJ, et al. Anorexia nervosa: treatment efficacy of cyproheptadine and amitriptyline. Arch Gen Psychiatry. 1986;43:177-181.[Abstract/Free Full Text]
• Attia E., Haiman C., Walsh BT, et al. Does fluoxetine augment the inpatient treatment of anorexia nervosa? Am J Psychiatry. 1998;155:548-551.[Abstract/Free Full Text]
• Kaye W., Gendall K., Strober M. Serotonin neuronal function and selective serotonin reuptake inhibitor treatment in anorexia and bulimia nervosa. Biol Psychiatry. 1998;44:825-838.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Gross HA, Ebert MH, Faden VB, et al. A double-blind controlled trial of lithium carbonate in primary anorexia nervosa. J Clin Psychopharmacol. 1981;1:376-381.[Web of Science][Medline] [Order article via Infotrieve]
• Dally P., Sargant W. A new treatment of anorexia nervosa. Br Med J. 1960;1:1770-1773.[Free Full Text]
• Vandereycken W., Pierloot R. Pimozide combined with behavior therapy in the short-term treatment of anorexia nervosa. Acta Psychiatr Scand. 1982;66:445-450.[Web of Science][Medline] [Order article via Infotrieve]
• Vandereycken W. Neuroleptics in the short-term treatment of anorexia nervosa: a double-blind placebo-controlled study with sulpiride. Br J Psychiatry. 1984;144:288-292.[Abstract/Free Full Text]
• Hansen L. Olanzapine in the treatement of anorexia nervosa. Br J Psychiatry. 1999;175:592.[Web of Science][Medline] [Order article via Infotrieve]
• La Via MC, Gray N., Kaye WH Case reports of olanzapine treatment of anorexia nervosa. Int J Eat Disord. 2000; 27:363-366.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Jensen VS, Mejlhede A. Anorexia nervosa: treatment with olanzapine. Br J Psychiatry. 2000;177:87.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Mondraty N., Birmingham CL, Touyz S., et al. Randomized controlled trial of olanzapine in the treatment of cognitions in anorexia nervosa. Australas Psychiatry. 2002;10:115-124.
• Södersten P., Bergh C., Ammar A. Anorexia nervosa: towards a neurobiologically based therapy. Eur J Pharmacol. 2003; 480:67-74.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Bergh C., Ejderhamn J., Södersten P. What is the evidence basis for existing treatments of eating disorders? Curr Opin Pediatr. 2003;15:344-345.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Janicak PG, Davis JM, Preskorn SH, Ayd FJ Principles and Practice of Psychopharmacotherapy. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2001.
• Umeki S. Biochemical abnormalities of the serum in anorexia nervosa. J Nerv Ment Dis. 1998;176:503-506.
• Ebeling H., Tapanainen P., Joutsenoja A., et al. A practice guideline for treatment of eating disorders in children and adolescents. Ann Med. 2003;35:488-501.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]

This version was published on December 1, 2007

Clinical Pediatrics, Vol. 46, No. 9, 806-811 (2007)
DOI: 10.1177/0009922807303929


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rossi, G. Articles by Lanzi, G. Search for Related Content PubMed PubMed Citation Articles by Rossi, G. Articles by Lanzi, G. Pubmed/NCBI databases Medline Plus Health Information Antidepressants Eating Disorders Social Bookmarking                         What's this?