title: Psychotropic medications in adult and adolescent eating disorders: clinical practice versus evidence-based recommendations.
abstract: OBJECTIVE
  The current study examined the frequency of psychotropic prescriptions in a clinical sample of eating disorder (ED) patients confirming earlier research indicating their use is very common but inconsistent with evidence-based recommendations.
  
  
  METHODS
  The sample consisted of 501 ED patients admitted to an adult partial hospitalization or adolescent residential program. Patients were divided into two diagnostic groups: anorexia nervosa (AN = 287) and bulimia nervosa (BN = 214), as well as two age groups: adults (age ≥18; N = 318) and adolescents (age <18; N = 183).
  
  
  RESULTS
  Forty-one different psychotropic medications (891 prescriptions in all) were prescribed for 429 patients. Overall, 85.6 % of the total sample reported using one or more psychotropic medications. Of 429 patients using any medications, 46.9 % were on two or more, 25.3 % on three or more, and 11.0 % four or more. Antidepressants were most commonly prescribed (89.5 % of those on medication) with no significant differences in usage patterns based on diagnosis. However, there was greater medication use among adults (89.6 %) compared to adolescents (78.7 %). Results indicate psychotropic medication prescription is more widespread in a clinical sample than in an earlier report screening for osteoporosis in AN women.
  
  
  CONCLUSIONS
  Treatment recommendations suggest medication should not be the primary treatment for EDs and empirical evidence demonstrates their ineffectiveness in AN. Nevertheless, there were no differences in frequency found between diagnostic groups, confirming little relationship between evidence-based recommendations and actual clinical use for those referred to a specialized ED treatment facility. This study adds new evidence regarding age-based comparisons of psychotropic prescription frequency in clinical EDs and comparison between AN and BN which has not been examined in earlier studies.
authors.affiliation: River Centre Clinic, 5465 Main Street, Sylvania, OH, 43560, USA. dm.garner@gmail.com.|River Centre Foundation, 5445 Main Street, Sylvania, OH, 43560, USA. dm.garner@gmail.com.
authors.forename: David M
authors.initials: DM
authors.lastname: Garner
authors.affiliation: River Centre Clinic, 5465 Main Street, Sylvania, OH, 43560, USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Anderson
authors.affiliation: River Centre Foundation, 5445 Main Street, Sylvania, OH, 43560, USA.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Keiper
authors.affiliation: University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH, 43614, USA.
authors.forename: Rachel
authors.initials: R
authors.lastname: Whynott
authors.affiliation: University of Toledo Medical Center, 3000 Arlington Avenue, Toledo, OH, 43614, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Parker
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002648:Child; D019317:Evidence-Based Medicine; D001068:Feeding and Eating Disorders / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D011619:Psychotropic Drugs
keywords: Anorexia nervosa; Anxiolytic; Atypical antipsychotic; Bulimia nervosa; Eating disorders; Mood stabilizer; Psychotropic medications; SSRI; Stimulant
references.citation: J Clin Psychiatry. 2012 Jun;73(6):e757-66
references.pmid: 22795216
references.citation: N Engl J Med. 2008 Jan 17;358(3):252-60
references.pmid: 18199864
references.citation: Psychol Med. 1982 Nov;12(4):871-8
references.pmid: 6961471
references.citation: Int J Eat Disord. 2013 May;46(4):332-9
references.pmid: 23001863
references.citation: Int Rev Psychiatry. 2008 Apr;20(2):183-8
references.pmid: 18386210
references.citation: Int J Eat Disord. 2009 Jan;42(1):1-8
references.pmid: 18683884
references.citation: Am J Psychiatry. 2010 Apr;167(4):409-17
references.pmid: 20080984
references.citation: J Eat Disord. 2014 Oct 30;2(1):27
references.pmid: 25379181
references.citation: J Affect Disord. 2011 May;130(3):470-7
references.pmid: 21109307
references.citation: Curr Ther Res Clin Exp. 2005 Nov;66(6):572-88
references.pmid: 24764595
references.citation: Int J Eat Disord. 2007 May;40(4):321-36
references.pmid: 17370288
references.citation: J Can Acad Child Adolesc Psychiatry. 2007 Nov;16(4):173-6
references.pmid: 18392170
references.citation: Clin Psychol Rev. 2003 Feb;23(1):57-74
references.pmid: 12559994
references.citation: Cochrane Database Syst Rev. 2006 Jan 25;(1):CD004365
references.pmid: 16437485
references.citation: Int J Eat Disord. 2012 Dec;45(8):970-6
references.pmid: 22733643
references.citation: Curr Pharm Des. 2004;10(20):2463-75
references.pmid: 15320756
references.citation: Int J Eat Disord. 2013 Jul;46(5):386-94
references.pmid: 23658076
references.citation: J Am Board Fam Pract. 2004 Mar-Apr;17(2):150-7
references.pmid: 15082675
references.citation: Int J Eat Disord. 2007 May;40(4):310-20
references.pmid: 17370290
references.citation: Int J Eat Disord. 2006 Jan;39(1):27-34
references.pmid: 16231336
references.citation: Int J Eat Disord. 2013 Jul;46(5):470-7
references.pmid: 23658094