The International Journal of Neuropsychopharmacology

Thematic Section: Eating Disorders and Obesity

Clinical psychopharmacology of eating disorders: a research update

Phillipa J. Haya1 c1 and Angélica M. Claudinoa2

a1 Foundation Chair of Mental Health, School of Medicine, University of Western Sydney and Adjunct Professor of Psychiatry, School of Medicine, James Cook University, Australia

a2 Head of Eating Disorders Programme (PROATA), Department of Psychiatry, Federal University of São Paulo, Brazil

Abstract

The paper presents a critical review (with search date 2010) of the major psychotropic medications assessed in eating disorders, namely antipsychotics, antidepressants, mood-stabilizing medications, anxiolytic and other agents. The evidence of efficacy of drug treatments is mostly weak or moderate. In addition, attrition rates are usually higher than for psychotherapies. However, there is support for use of antidepressants, particularly high-dose fluoxetine in bulimia nervosa, and anticonvulsants (topiramate) for binge-eating disorder. Low-dose antipsychotic medication may be clinically useful as adjunct treatment in acute anorexia, particularly where there is high anxiety and obsessive eating-related ruminations and failure to engage, but more trials are needed. Drug therapies such as topiramate and anti-obesity medication may aid weight loss in obese or overweight patients with binge-eating disorder; however, common or potentially serious adverse effects limit their use.

(Received November 24 2010)

(Reviewed January 10 2011)

(Revised February 06 2011)

(Accepted February 21 2011)

(Online publication March 25 2011)

Correspondence:

c1 Address for correspondence: Professor P. J. Hay, School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith South DC 1797, NSW, Australia. Tel.: +61 2 46203668 Fax: +61 2 46203891 Email: p.hay@uws.edu.au