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

Martin Aigner, Janet Treasure, Walter Kaye, Siegfried Kasper, Ursula Bailer, Francesca Brambilla, Cynthia Bulik, Taki Athanasios Cordas, Roland Dardennes, Martina De Zwaan, Fernando Fernandez-Aranda, Serguei Fetissov, Manfred Fichter, Katherine Halmi, Hans Hoek, Andreas Karwautz, Nobuo Kiriike, Andrea Lopez-Mato, Joao Eduardo Mendonca Vilela, James MitchellPalmiero Monteleone, Hana Papezova, Maria Råstam, Zoltan Rihmer, Howard Steiger, Daniel Stein, Tudor Udristoiu, Cezary Zechowski

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives. The treatment of eating disorders is a complex process that relies not only on the use of psychotropic drugs but should include also nutritional counselling, psychotherapy and the treatment of the medical complications, where they are present. In this review recommendations for the pharmacological treatment of eating disorders (anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED)) are presented, based on the available literature. Methods. The guidelines for the pharmacological treatment of eating disorders are based on studies published between 1977 and 2010. A search of the literature included: anorexia nervosa bulimia nervosa, eating disorder and binge eating disorder. Many compounds have been studied in the therapy of eating disorders (AN: antidepressants (TCA, SSRIs), antipsychotics, antihistaminics, prokinetic agents, zinc, Lithium, naltrexone, human growth hormone, cannabis, clonidine and tube feeding; BN: antidepressants (TCA, SSRIs, RIMA, NRI, other AD), antiepileptics, odansetron, d-fenfluramine Lithium, naltrexone, methylphenidate and light therapy; BED: antidepressants (TCA, SSRIs, SNRIs, NRI), antiepileptics, baclofen, orlistat, d-fenfluramine, naltrexone). Results. In AN 20 randomized controlled trials (RCT) could be identified. For zinc supplementation there is a grade B evidence for AN. For olanzapine there is a category grade B evidence for weight gain. For the other atypical antipsychotics there is grade C evidence. In BN 36 RCT could be identified. For tricyclic antidepressants a grade A evidence exists with a moderate-risk-benefit ratio. For fluoxetine a category grade A evidence exists with a good risk-benefit ratio. For topiramate a grade 2 recommendation can be made. In BED 26 RCT could be identified. For the SSRI sertraline and the antiepileptic topiramate a grade A evidence exists, with different recommendation grades. Conclusions. 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


Read More: http://informahealthcare.com/doi/abs/10.3109/15622975.2011.602720
Original languageEnglish
Pages (from-to)400-443
JournalWorld Journal of Biological Psychiatry
Volume12
Issue number6
DOIs
Publication statusPublished - 2011

Subject classification (UKÄ)

  • Psychiatry

Free keywords

  • antiepileptics
  • antipsychotics
  • antidepressants
  • pharmacotherapy
  • Bulimia nervosa
  • Binge Eating Disorder
  • Anorexia nervosa
  • guidelines
  • eating disorder
  • drug treatment
  • antihistaminics
  • tube feeding
  • light therapy

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