Use of Antipsychotics in the Treatment of Eating Disorders
Anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are the most common eating disorders (EDs). The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) also describes avoidant/restrictive food intake
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Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Studies Testing Antipsychotics in Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Meta-Analyses of Antipsychotics in Eating Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Neuronal and Molecular Pharmacodynamic Mechanisms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Clinical Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Limitations and Future Research Directions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Cross-References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Abstract
Anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are the most common eating disorders (EDs). The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) also describes avoidant/ restrictive food intake disorder (ARFID), pica, and rumination disorder as types of ED, for which there are currently no psychopharmacological randomized controlled trials (RCTs) reported in the literature. First-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) have been assessed in patients with AN, but not for those with BN or BED. Studies in patients with AN on the FGAs sulpiride and pimozide, and on the SGAs amisulpride, quetiapine and risperidone have not revealed convincing treatment success in comparison to placebo. One small (N ¼ 13), open, K. Borges Faculty of Life Sciences and Medicine, King’s College London, London, UK e-mail: [email protected] Y. D. Lewis Hadarim Eating Disorders Unit, Shalvata Mental Health Center, Hod Hasharon, Israel J. Bentley · H. Himmerich (*) Department of Psychological Medicine, King’s College London, London, UK e-mail: [email protected]; [email protected] © Springer Nature Switzerland AG 2020 P. Riederer, G. Laux et al. (eds.), NeuroPsychopharmacotherapy, https://doi.org/10.1007/978-3-319-56015-1_388-1
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K. Borges et al.
uncontrolled study investigating the FGA haloperidol demonstrated an increase in weight and an improvement in ED symptoms. In a retrospective, case-controlled study in adolescent inpatients with AN (N ¼ 106), 22 of which had been treated with the SGA aripiprazole, it was found that those who took aripiprazole experienced significantly greater weight gain. The most convincing evidence for t
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