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Medication for eating disorders blog 1: Are medications useful for eating disorders?

Medication Blog ImageBy Deborah Etienne-Ward

Psychotropic medication refers to medication that has the purpose of managing mental illness by altering mood, and having a sedating and/or antidepressant effect (Black Dog Institute, 2014). There are four broad types of psychotropic medications. These include: Anti-depressants, Anti-psychotics, Mood Stabilisers, and Benzodiazepines. Sometimes these medications are prescribed to people with an Eating Disorder. The prescription of these drugs can be daunting for patients and their parents and/or partners. In an attempt to address some common concerns that arise as a result of the prescription of psychotropic medication, a series of blogs will be published over the coming weeks covering a range of topics including:

  • “Are medications helpful for Eating Disorders?”
  • “Will medications change me as a person?”
  • “Will these medications cause me to gain weight?”
  • “I don’t want to be a person that needs medication”
  • “Will I be on medication forever?”
  • Tip Sheet for Parents and Partners

This article forms the first of the series about medication and will address the usefulness of medication in Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder.

Common Psychotropic Medications

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A larger medication chart can be found at here.


Are Psychotropic Medications useful for Eating Disorders?

Anorexia Nervosa

Psychotropic medication has generally been found to have little effect in the direct treatment of Anorexia Nervosa (Preston, O’Neal, & Talaga, 2013; Harrington et al., 2015). However, psychotropic medication can be very useful for reducing many of the co-occurring symptoms that are often present in people with Anorexia Nervosa. For example, antipsychotics may be useful to reduce obsessive-compulsive thoughts, aggression, persistence, and interpersonal distrust (Brewerton, 2012). Furthermore, anti-depressant medication can be helpful in managing depressive symptoms and suicidal ideation (Harrington et al., 2015). Additionally, benzodiazepines can be useful in reducing anxiety experienced by people with Anorexia Nervosa particularly during the re-feeding stage of therapy (Kruger & Kennedy, 2000). Whilst, psychotropic medication should not replace evidence based psychological therapy it can complement therapy by assisting clients to overcome particular obstacles that arise.

Bulimia Nervosa

Psychotropic medication, specifically anti-depressant medication, shows great promise in the treatment of Bulimia Nervosa. Research has shown that approximately 40% to 70% of people with Bulimia Nervosa show improvement with anti-depressant medication (Preston, O’Neal, & Talaga, 2013). One commonly prescribed type of anti-depressant is called a Selective Serotonin Reuptake Inhibitor (SSRI). SSRI’s and in particular, Fluoxetine (e.g. Prozac), has been shown to decrease the incidence of binge eating and purging (Aigner, 2011). As a result, anti-depressant medication is commonly included, along with psychological therapy, in intervention plans.

Other types of psychotropic medication are usually only prescribed for a patient with Bulimia Nervosa if the patient presents with a co-occurring disorder (Kruger & Kennedy, 2000).

Binge Eating Disorder

The research into the effectiveness of psychotropic medication for Binge Eating Disorder is still in its infancy. However, similar to Bulimia Nervosa anti-depressant medication appears to reduce binge eating episodes. There is also some research to suggest that antidepressants may help in reducing the Body Mass Index (BMI) of a person that has Binge Eating Disorder (Kruger & Kennedy, 2000).

Psychological Therapy

Whilst medication may help to alleviate symptoms, eating disorders should also be treated using psychological intervention such as Cognitive Behavioural Therapy (CBT) to treat issues that underlie the disorder. Best outcomes for recovery are frequently achieved through a combination of psychotropic medication and evidence-based psychological therapy.

Disclaimer: The information provided in this article is general only and individual advice regarding psychotropic medication should be sought from your GP or Psychiatrist.

References:

Aigner, M., Treasure, J., Kaye, W., Kasper, S. & The WFSBP Task Force on Eating Disorders. (2011). World Federation of Societies of Biological Psychiatry (WFSBP). Guidelines for the Pharmacological treatment of Eating Disorders. The World Journal of Biological Psychiatry, 12, 400-443.

Black Dog Institute. (2014). Research Findings. Retrieved from http://www.blackdoginstitute.org.au/public/research/PsychotropicMedicationsincreasedprescriptionandwiderapplication.cfm

Brewerton, T.D., Antipsychotic Agents in the Treatment of Anorexia Nervosa: Neuropsychpharmacologic Rationale and Evidence from Controlled Trials. Current Psychiatry Reports. 14, 398-405.

Harrington, B.C., Jimerson, M., Haxton, C., & Jimerson, D.C. (2015). Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa. American Family Physician. 91(1), 46-52.

Kruger, S., & Kennedy, S.H. (2000). Psychopharmacotherapy of anorexia nervosa, bulimia nervosa and binge-eating disorder. Journal of Psychiatry and Neuroscience, 25(5), 497-508.

Preston, J.D., O’Neal, J.H., & Talaga, M.C. (2013). Handbook of Clinical Psychopharmacology for Therapists. Oakland, CA: New Harbinger Publications.