Psychopharmacology in the Treatment of Eating Disorders

Abstract

Given the high morbidity and mortality rates associated with eating disorders (EDs), many studies have examined the use of medications to treat these disorders. However, with the exception of fluoxetine (for those 12 years and older with bulimia nervosa) and lisdexamfetamine (for adults with moderate-to-severe binge eating disorder), no other medications have been approved by the United States Food and Drug Administration to treat any eating disorder. This article will review many of the positive and negative studies for use of medication in the treatment of eating disorders, including anorexia nervosa, bulimia nervosa, atypical anorexia nervosa, avoidant/restrictive food intake disorder, and binge eating disorder. Various classes of medication will be reviewed, including antidepressants, antipsychotics, mood stabilizers, and anxiolytics. Although the information in this article is important in the education of both patients and their parents, medications should be used cautiously in those with EDs. It should be emphasized that to date, therapy—family-based therapy and enhanced cognitive behavioral therapy—is the mainstay of treatment, with nutrition therapy and correction of malnutrition as the crucial first step in treatment.