title: World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of eating disorders.
abstract: OBJECTIVE
  The treatment of eating disorders is a complex process that relies not only on the use of psychotropic drugs but should include also nutritional counselling, psychotherapy and the treatment of the medical complications, where they are present. In this review recommendations for the pharmacological treatment of eating disorders (anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED)) are presented, based on the available literature.
  
  
  METHODS
  The guidelines for the pharmacological treatment of eating disorders are based on studies published between 1977 and 2010. A search of the literature included: anorexia nervosa bulimia nervosa, eating disorder and binge eating disorder. Many compounds have been studied in the therapy of eating disorders (AN: antidepressants (TCA, SSRIs), antipsychotics, antihistaminics, prokinetic agents, zinc, Lithium, naltrexone, human growth hormone, cannabis, clonidine and tube feeding; BN: antidepressants (TCA, SSRIs, RIMA, NRI, other AD), antiepileptics, odansetron, d-fenfluramine Lithium, naltrexone, methylphenidate and light therapy; BED: antidepressants (TCA, SSRIs, SNRIs, NRI), antiepileptics, baclofen, orlistat, d-fenfluramine, naltrexone).
  
  
  RESULTS
  In AN 20 randomized controlled trials (RCT) could be identified. For zinc supplementation there is a grade B evidence for AN. For olanzapine there is a category grade B evidence for weight gain. For the other atypical antipsychotics there is grade C evidence. In BN 36 RCT could be identified. For tricyclic antidepressants a grade A evidence exists with a moderate-risk-benefit ratio. For fluoxetine a category grade A evidence exists with a good risk-benefit ratio. For topiramate a grade 2 recommendation can be made. In BED 26 RCT could be identified. For the SSRI sertraline and the antiepileptic topiramate a grade A evidence exists, with different recommendation grades.
  
  
  CONCLUSIONS
  Additional research is needed for the improvement of the treatment of eating disorders. Especially for anorexia nervosa there is a need for further pharmacological treatment strategies.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University Vienna (MUW), Vienna, Austria. martin.aigner@meduniwien.ac.at
authors.forename: Martin
authors.initials: M
authors.lastname: Aigner
authors.forename: Janet
authors.initials: J
authors.lastname: Treasure
authors.forename: Walter
authors.initials: W
authors.lastname: Kaye
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D000856:Anorexia Nervosa / Q000188:drug therapy*; D000927:Anticonvulsants / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D056912:Binge-Eating Disorder / Q000188:drug therapy*; D052018:Bulimia Nervosa / Q000188:drug therapy*; D001068:Feeding and Eating Disorders / Q000145:classification / Q000150:complications / Q000188:drug therapy; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents