Biological Treatment for Anorexia: Drug Therapy

Question 1

NICE Guideline

Answer 1

• Doesn’t recommend to use drug therapy as a first choice for AN as they affect weight gain and depression
• They are not too effective in terms of symptoms demonstrated when used alone, drugs are usually a part of other therapies as part of a treatment and support program

Question 2

SSRI: Selective Serotonin Re-uptake Inhibitor

Answer 2

• An antidepressant drugs which blocks serotonin receptors and prevent the serotonin in the synapse to be reabsorbed into the neuron which increase the overall availability of serotonin in the synapse
• Serotonin is deactivated in the synapse by re uptake into the pre-synaptic neuron
• SSRI block the reuptake from the terminal button which increases the activation of serotonin receptors

Question 3

SSRI and ventromedial

Answer 3

• Only the ventromedial has over activity leading to fullness and anxiety
• Patients with condition such as depression and anxiety when using SSRI can treat the symptoms making them able to ready for psychological therapies

Question 4

Example of SSRI

Answer 4

• Fluoxetine

Question 5

Anti psychotics

Answer 5

• Act as dopamine antagonists by occupying dopamine D2 receptors, but don’t activate the receptors
• They can lessen the effect of dopamine but not the availability
• They block the receptors on the dendrites preventing activation of dopamine therefore lessening dopamine activity

Question 6

Example of Antipsychotics

Answer 6

• Olanzapine
• It is a new Anti psychotic which targets both dopamine receptors and serotonin receptors and also has an effect on weight gain and reduce obsessive thoughts about food

Question 7

Strength about Biological Treatment for AN
(2)

Answer 7

• One strength is that case studies, it shows that drugs seem to improve anorexia symptoms
• Boachie et al used olanzapine to treat 4 children with anorexia. These children gained significant amounts of weight when taking the drugs and experienced less anxiety during mealtimes
• This demonstrates that atypical antipsychotics are a class of drugs that have the potential in treating anorexia symptoms of extremely low body weight

-Another strength is that atypical antipsychotics drugs seem to improve anorexia symptoms
- Jensen and Mejlhede found case studies of 3 patients who took olanzapine, the patients showed an increase in positive body image which was also more realistic of what they actually look like
- This demonstrates that atypical antipsychotics can also help treat the symptoms of distorted perception of one’s body size

Question 8

Weakness of Biological Treatment of AN

Answer 8

• A weakness is that in systematic review of studies, the effectiveness of drugs in treating anorexia is challenged
• Lebow et al found that people with anorexia who take atypical antipsychotics have an increase in BMI and body satisfaction but it wasn’t significantly to those in placebo groups and in some instance, it was associated with greater anxiety and worse overall symptoms when compared to controls
• This demonstrates that as a whole drugs therapies may not be an effective treatment for anorexia