[MEDICATIONS]
The Silent Suffering
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Common medicaions used in the treatment of eating disorders
UNDER CONSTRUCTION
*Selective Serotonin Reuptake Inhibitors (SSRI's)
Also referred to as "Antidepressants", SSRI's are often used in the treatment of depression, anxiety and personality disorders. According to Wikipedia, "SSRIs increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin available to bind to the postsynaptic receptor. They have varying degrees of selectivity for the other monoamine transporters, with pure SSRIs having only weak affinity for the noradrenaline and dopamine transporter. The first class of psychotropic drugs to be rationally designed, SSRIs are the most widely prescribed antidepressants in many countries."
Commonly Used SSRI's
Escitalopram (Lexapro)
Citalopram (Celexa)
Sertraline (Zoloft)
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
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*Serotonin Norepinephrine Reuptake Inhibitors (SNRI's)
According to Wikipedia : "Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant drugs used in the treatment of major depression and other mood disorders. They are sometimes also used to treat anxiety disorders, obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), chronic neuropathic pain, fibromyalgia syndrome (FMS), and for the relief of menopausal symptoms.
SNRIs act upon and increase the levels of two neurotransmitters in the brain that are known to play an important part in mood, these being serotonin and norepinephrine. This can be contrasted with the more widely-used selective serotonin reuptake inhibitors (SSRIs) which act more selectively on serotonin."
Commonly Used SNRI's
Venlafaxine (Effexor)
Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
Other Types of Medications
Tricyclic Antidepressants
MAOI's
Sources:
"Selective Serotonin Reuptake Inhibitor." Wikipedia.org. Web. 24 Nov. 2009. http:www.wikipedia.org.
Benefits of Medications
-They can be quite helpful in dealing with co-existing or related disorders, which may contribute to the severity of your eating disorder.
-They may help to reduce stress and anxiety surrounding meals.
-Some meds can help with appetite.
-With therapy, medications can aid the sufferer in working through causes and triggers, which can improve the recovery process.
-Some medications can help control the binge or purge urges, which can be very beneficial for Bulimia or Compulsive Overeating.
Drawbacks
-Not everyone will benefit from taking medications, it really depends on your unique situation.
-There are few medications indicated to treat the eating disorder itself. As mentioned above, medications often work best with symptoms of co-existing disorders like depression.
-Medications are essentially a "band aid". It is not a replacement for therapy and working through the issues at hand. There are no 'miracle pills'. They cannot be relied upon to make things better on their own.
-Malnutrition can hinder the effectiveness of medications, which would obviously present some problems with treating eating disorders.
-Appetite isn't really the issue at hand for eating disorders. No one or no thing can really force you to not binge or to eat a normal sized meal. So, this beneift can be limited in some cases.
-Anorexia is quite resistent to medication therapy.
Anorexia & Medications
(written by Carolyn Costin for HealthyPlace.Com - for more information see the source section of this page)
"Despite what many think, anorexia nervosa has so far been shown to be relatively resistant to treatment with drugs. Many medicines have been tried for various reasons, with a report here and there about the effectiveness of a certain medicine in certain cases, but overall none has been shown in controlled studies to have any particular effectiveness with the core issues of anorexia nervosa. Even tetrahydrocannabinol (marijuana) was clinically tried in hopes of stimulating appetite (causing the "munchies") but it produced only unhappy moods instead.
An encouraging study was reported by Dr. Walter Kaye at the International Association of Eating Disorder Professionals conference in August 1995. The breakthrough was discovered in a placebo-controlled medication trial of fluoxetine (Prozac) with anorexics. Prozac, and less so sertraline (Zoloft), fluvoxamine (Luvox), and paroxetine (Paxil), are the most commonly known of the group of antidepressants referred to as selective serotonin reuptake inhibitors (SSRIs). Until recently even these medications, the drugs of choice for the treatment of bulimia nervosa, showed no efficacy with anorexia nervosa.
However, according to Walter Kaye, fluoxetine (Prozac) did show significant results in anorexia, but with a crucial difference in how it was used. When administered after nutritional rehabilitation and weight restoration, fluoxetine showed significant advantages over a placebo in preventing the all-too-common relapse. This appears to work by the drug's causing a significant reduction in obsessions and compulsions related to food and body image. More research needs to be done, but for now it seems that initially behavioral and nutritional therapy should be the foundation of treatment for anorexia nervosa, with the use of fluoxetine and perhaps even other SSRIs as an adjunct to prevent relapse once weight gain has been achieved. "
Bulimia Nervosa & Medications
"The use of psychotropic agents in treating bulimia nervosa has been much more promising than in treating anorexia nervosa. Most drug trials have been with antidepressants, particularly the newer SSRIs, which have shown significantly greater improvement in bingepurge frequency compared to placebo. Antidepressant medication doesn't work for everyone; some patients (about 20 to 33 percent) have complete remission of symptoms, and others have significant reductions in bingeing and purging behaviors.
The class of antidepressants known as the SSRIs, discussed above, such as Prozac, Zoloft, and so on, are the newer versions of antidepressants since the original tricyclics and MAOIs (mono-amine oxidase inhibitors). Tricyclics such as desiprimine and imipramine showed effectiveness but had many side effects, such as weight gain, which were not well tolerated by eating disordered patients. amitriptyline (Elavil) was studied but was no better than placebo.
Additionally, tricyclic overdose is the third leading cause of death in emergency rooms and, as such, is extremely dangerous in depressed patients, the very ones it most effectively treats. The lethality of tricyclic overdose is only enhanced by the medical effects of eating disorders, especially lowered potassium in the body (hypokalemia).
The MAOIs such as tranylcypromine (Parnate) and phenelzine (Nardil) show efficacy in reducing bulimic symptoms. However, individuals taking MAOIs must be on a very restrictive low tyrosine (an amino acid) diet that, if broken, can cause a hypertensive crisis (very high blood pressure, possibly resulting in serious side effects such as stroke or death). Of the SSRIs, only Prozac (Fluoxetine) has really been shown to decrease bulimic symptoms such as poor regulation of hunger and satiety, sensitivity to stress, and obsessive thinking and behavior, without undue side effects. For more information on SSRIs and their side effects, refer to the section on page 222 that describes the psychotropic medications most commonly used in eating disorders."
Binge Eating Disorder
"As has been previously stated, the research on BED (including drug studies) is minimal but growing. However, several investigators believe that binge eating is less a matter of willpower than brain chemistry. In some cases, clinicians and researchers are using SSRIs with binge eating disorder for the same reasons they use it for bulimia. Serotonin helps us feel full, so it is theorized that people with binge eating disorders like bulimia nervosa may want to eat all the time because they have too little of the neurotransmitter serotonin and thus never feel satisfied (satiated)."
** There are pros and cons to medication therapy, and it is really up to you and your medical or psychiatric care provider to weigh your options and decide how beneficial they will be for you. I can neither support or dispute the use of medication for your particular situation. This page is meant to be used for educational purposes only**
Source
Costin, Carolyn. "Medication for Treating Eating Disorders." HealthyPlace.com. Healthy Place, 17 Nov. 2008. Web. 28 Oct. 2009. <http://www.healthyplace.com>.
