Anorexia nervosa: One biological treatment

Question 1

How do SSRI’s (antidepressant) treat depression?

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Answer 1

• > Reuptake of sero at synapse, ^availability in neurotransmission

Question 2

Why are SSRI’s (antidepressant) of interest if only treating depression?
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Answer 2

• > Sero play role in AN

- Through co morbid disorders (depression)

Question 3

Can you describe the normal process if there is serotonin remaining?
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Answer 3

• Sero molecules in synapse removed via reuptake (sero transporters)

Question 4

How does SSRI’s interfere with reuptake of serotonin and treat AN?
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Answer 4

• Usual pathway blocked
• Excess sero not recycled, stays in synapse to be reused
• Extends appetite enhancing effects of sero via repeated binding w receptors on post synaptic neuron

Question 5

What is the role of SNRI’s (newer antidepressant)?

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Answer 5

• Target noradrenaline and sero

- Inhibiting reuptake of both NT’s

Question 6

How do antipsychotics (most = dopamine agonists) interact with dopamine?
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Answer 6

• Block postsynaptic dopa receptors w/out activating them

- >Overall activity of dopamine, doesn’t >availability of dopa

Question 7

What are the reasons for using antipsychotics as treatment for AN?
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Answer 7

• Counter distorted cognitions (fatness)

- Counter less appetite from disrupted dopa system, reward system fail to +reinforce eating

Question 8

How may olanzapine (SGA) treat AN?

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Answer 8

• When treating schizo = Weight gain side effect

- >anorexic ruminations of body shape

Question 9

What are the weaknesses of olanzapine?

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Answer 9

• Weak antagonist of sero

- Block D2/D3 dopa/sero 5-HT2 receptors, influencing symptoms

Question 10

What did Zwaal et al. find and how can this treat AN?

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Answer 10

• Olanzapine = ^secretion of hormone ghrelin

- ^Ghrelin = >feelings of fullness after eating

Question 11

Evaluate drugs as a treatment for AN

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Answer 11

Boachie et al. used olanzapine to treat 4 AN children. They gained sig weight (just under 1k every week). Experienced >anxiety at mealtimes, better sleep, few side effects.

Lebow et al. found people w AN who take SGA’s = ^BMI and ^body satisfaction. But those improvements not too diff from placebo group. Drugs = associated w ^anxiety and worse overall symp compared w ctrl.

Drugs may >symptoms of AN by stabilising dysfunctional NT systems in brain. This isn’t same as treating the cause (genetic?), temporary reduction of symp, if they stopped taking symp reversed. CBT ^preferable