psychiatric treatment for eating disorders

Anorexia
Although medication is frequently used in the treatment of anorexia, there
is little evidence to support its effi cacy in acute stages of the illness. Antipsychotics,
lithium, various antidepressants, and appetite stimulants have
all produced disappointing results (Zhu & Walsh, 2002). Although there are
promising case reports on the use of the antipsychotic olanzapine (Jensen &
Mejihede, 2000; La Via, Gray, & Kaye, 2000), to date there have been no scientifi
c studies published on its eff ectiveness. Studies also suggest that fl uoxetine
helps to prevent relapse among patients who have attained a healthy weight
(Peterson & Mitchell, 1999).
Bulimia
A substantial number of studies have found that the various antidepressants
are equally eff ective in the treatment of bulimia. Fluoxetine, studied the mostextensively, is known to reduce anxiety and depression as well as purging and
bingeing. Few studies, however, have demonstrated its long-term eff ectiveness.
CBT has been found to be superior to medication alone. Although medication
enhances the eff ectiveness of CBT, it is unclear by how much. Existing research
suggests that antidepressants may augment psychotherapy for some bulimic
individuals but should not be the sole intervention (Zhu & Walsh, 2002).
Binge Eating Disorder
Research on the pharmacological treatment of BED is preliminary. Although
antidepressants, appetite suppressants, and anticonvulsants have all shown
promise, the selective serotonin reuptake inhibitors (SSRIs) have been studied
the most and cause the fewest side eff ects. If used, higher-end doses given for
6 to 12 months are recommended (Carter et al., 2003).
As with bulimia, CBT has been found to be superior to medication alone
in the treatment of BED (Devlin, 2002; Ricca et al., 2001). Whether antidepressants
enhance the eff ects of CBT has not yet been empirically established
(Wonderlich et. al, 2003).