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

Aigner, Martin; Treasure, Janet; Kaye, Walter; Kasper, Siegfried; Bailer, Ursula; Brambilla, Francesca; Bulik, Cynthia; Athanasios Cordas, Taki; Dardennes, Roland and De Zwaan, Martina, et al. (2011) In World Journal of Biological Psychiatry 12(6). p.400-443
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... (More)
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





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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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World Journal of Biological Psychiatry
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12
issue
6
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400 - 443
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Taylor & Francis
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1562-2975
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10.3109/15622975.2011.602720
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English
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http://www.ncbi.nlm.nih.gov/pubmed/21961502
http://informahealthcare.com/doi/abs/10.3109/15622975.2011.602720
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@article{a456593c-a8ce-418d-8707-f1847834483f,
  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<br/><br>
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Read More: http://informahealthcare.com/doi/abs/10.3109/15622975.2011.602720},
  author       = {Aigner, Martin and Treasure, Janet and Kaye, Walter and Kasper, Siegfried and Bailer, Ursula and Brambilla, Francesca and Bulik, Cynthia and Athanasios Cordas, Taki and Dardennes, Roland and De Zwaan, Martina and Fernandez-Aranda, Fernando and Fetissov, Serguei and Fichter, Manfred and Halmi, Katherine and Hoek, Hans and Karwautz, Andreas and Kiriike, Nobuo and Lopez-Mato, Andrea and Mendonca Vilela, Joao Eduardo and Mitchell, James and Monteleone, Palmiero and Papezova, Hana and Råstam, Maria and Rihmer, Zoltan and Steiger, Howard and Stein, Daniel and Udristoiu, Tudor and Zechowski, Cezary},
  issn         = {1562-2975},
  keyword      = {antiepileptics,antipsychotics,antidepressants,pharmacotherapy,Bulimia nervosa,Binge Eating Disorder,Anorexia nervosa,guidelines,eating disorder,drug treatment,antihistaminics,tube feeding,light therapy},
  language     = {eng},
  number       = {6},
  pages        = {400--443},
  publisher    = {Taylor & Francis},
  series       = {World Journal of Biological Psychiatry},
  title        = {World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Eating Disorders},
  url          = {http://dx.doi.org/10.3109/15622975.2011.602720},
  volume       = {12},
  year         = {2011},
}