Medication management of pediatric eating disorders.
This article provides an overview of psychopharmacological treatments for pediatric eating disorders (EDs). Although EDs usually begin in adolescence, there are few pharmacological treatment trials specific to this age group and a paucity of controlled data. Empirical evidence suggests that psychological, behavioural and family interventions should be the primary modalities of treatment for these conditions. In severely underweight patients behavioural weight restoration should be attempted before pharmacological intervention, especially since starvation is known to aggravate obsessional and depressive symptomatology. Evidence from controlled trials supports the use of antidepressants for the treatment of bulimia nervosa (BN) in adults; however, similar studies have not yet been performed in youths. For anorexia nervosa (AN), there are no pharmacotherapies of proven efficacy in either adults or youths. Nonetheless, clinical experience and uncontrolled evidence suggests that some children and adolescents may benefit from thoughtful use of psychotropic medications on an individual basis in the context of a multimodal treatment plan. Regarding binge eating disorder (BED), adult literature shows positive short-term effects on binge eating for both pharmacological (especially selective serotonin reuptake inhibitors) and behavioural interventions, but unclear effects on weight. Clearly, psychopharmacological interventions for pediatric EDs would benefit from more research.
Reinblatt
Shauna Pencer
SP
Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. sreinbl1@jhmi.edu
Redgrave
Graham W
GW
Guarda
Angela S
AS
D000856:Anorexia Nervosa / Q000188:drug therapy; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D052018:Bulimia Nervosa / Q000188:drug therapy; D002648:Child; D001068:Feeding and Eating Disorders / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome
D000928:Antidepressive Agents