title: Pharmacologic and Psychotherapeutic Treatment of Anorexia Nervosa.
abstract: This article will review the treatment research literature on patients with anorexia nervosa. Perhaps somewhat surprisingly, the controlled treatment literature on this disorder is fairly limited. This is attributable to several factors, including the fact that many patients with anorexia nervosa are difficult to engage in treatment and unwilling to participate in randomized trials, and that many of these patients are so critically ill that they require a multiplicity of interventions and long-term therapy, creating design problems for randomized trials. Nonetheless, the extant literature will be reviewed, including pharmacologic and psychotherapeutic interventions in adolescents and adults. One point that needs to be addressed at the outset is the proper venue for the treatment of anorexia nervosa. Many patients, particularly those very low in weight, require in-patient and/or partial hospital treatment as the initial intervention. Although third-party payers are increasingly reluctant to pay for such interventions, they remain the treatments of choice for many anorectic patients. Another issue concerns acute treatment, focusing on weight gain, versus relapse prevention, focusing on weight maintenance and further work on anorectic psychopathology. Different studies have focused on different areas.
authors.affiliation: 1 The Neuropsychiatric Research Institute, 700 1st Avenue South, PO Box 1415, Fargo, ND 58107, USA, Tel.: +1 701 293 1335; Fax: +1 701 293 3226; E-mail: mitchell@medicine.nodak.edu.|2 The University of North Dakota, School of Medicine and Health Sciences, The Department of Clinical Neuroscience, Fargo, ND 58102, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.affiliation: 1 The Neuropsychiatric Research Institute, 700 1st Avenue South, PO Box 1415, Fargo, ND 58107, USA, Tel.: +1 701 293 1335; Fax: +1 701 293 3226; E-mail: mitchell@medicine.nodak.edu.|3 North Dakota State University, The School of Pharmacy, Fargo, ND 58105, USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Steffen
authors.affiliation: 1 The Neuropsychiatric Research Institute, 700 1st Avenue South, PO Box 1415, Fargo, ND 58107, USA, Tel.: +1 701 293 1335; Fax: +1 701 293 3226; E-mail: mitchell@medicine.nodak.edu.|2 The University of North Dakota, School of Medicine and Health Sciences, The Department of Clinical Neuroscience, Fargo, ND 58102, USA.
authors.forename: Tricia Cook
authors.initials: TC
authors.lastname: Myers
authors.affiliation: 1 The Neuropsychiatric Research Institute, 700 1st Avenue South, PO Box 1415, Fargo, ND 58107, USA, Tel.: +1 701 293 1335; Fax: +1 701 293 3226; E-mail: mitchell@medicine.nodak.edu.|2 The University of North Dakota, School of Medicine and Health Sciences, The Department of Clinical Neuroscience, Fargo, ND 58102, USA.
authors.forename: James
authors.initials: J
authors.lastname: Roerig
keywords: anorexia nervosa; pharmacotherapy; psychotherapy; treatment