Drug Treatment For AN Flashcards
What is the rationale behind drug treatment for AN?
Low levels of some neurotransmitters (NTs) such as serotonin and noradrenaline are found in acutely ill anorexia sufferers.
What is the serotonin associated with?
The suppression of appetite and mood.
How is AN caused by low serotonin?
Low serotonin levels are linked to binging and depression, and persistent disruption or serotonin levels lead to increased anxiety around food which can trigger AN.
What are drugs for AN used for?
To treat co-morbid factors such as depression and anxiety which have occurred as a result of having a disorder. Therefore drug treatment is not the first type of treatment used as they dont help with core symptoms such as weight loss.
What are SSRIs?
AN is associated either with serotonin which links to food and appetite. Low levels tend to be linked with depression too as serotonin regulates pleasure. Serotonin dysfunction can remain after recovery therefore drugs are necessary in order to combat these co-morbid symptoms.
What is Fluoxetine?
It’s a class of drugs known as SSRIs and these dugs stand for selective serotonin uptake inhibitors. These dugs increase serotonin levels and in turn this will deacrse depressive modes and anxiety surrounding eating for patients with AN.
How do SSIRs work?
They help make serotonin available by blocking the re uptake process. This allows serotonin to built up between neuron’s so messages can be sent correctly. They’ve called ‘selective’ serotonin re uptake inhibitors because they specifically target serotonin.
How are antipsychotics used to treat AN?
They woke the same way they do for SZ. The first generation drugs focus mainly on dopamine hypothesis and function. They are used due to the suggestion that altered dopamine functioning in the striatum may contribute to AN. Some can also impact serotonin levels, such as second generation antipsychotics which tend to be the more popular out the two as we know serotonin links more with appetite and motivation to eat food for pleasure.
What is the striatum?
It’s associated with the movement and mediating rewarding experiences, therefore has strong links to reward pathways. Perhaps people with AN lack functioning here and as a result do not feel pleasure and rewarded for eating foods/.
What are the side effects for using SSRIs?
- Pain in the joints or muscles
- Reduced sex drive
- Dry mouth
- Feeling dizzy
Why are SSRIs prescribed specifically?
They are said to give the side effect of weight gain. This is good for someone with AN as the ultimate goal is to make they gain weight. However this might be a tough side effect to cope with due to the nature of their illness. This may means that patients struggle to continue taking medication if they are not receiving additional treatment.
Research on taking SSRIs as medication (weakness)
Some children/young adults may be more likely to have suicidal thoughts when they take SSIRs. Studies have shown that when compared to results from taking a placebo, chances of having suicidal thoughts doubles - from between 1 and 2% to between 2-4% when taking any kind of anti-depressant, including an SSRI.
Strength - successful
It aims to teat co-morbid factors and does so effectively. A patient with anxiety along side AN is less likely to drop out of therapy is they are also treated with drugs. If the co-morbid conditions can be managed, it may make other therapies more successful.
Weakness - tablet form medication
Rosenhan found that when 2100 pills were prescribed to pseudo patients ‘which schizophrenia’ only 2 were actually swollen. This shows that patients are good at hiding whether or not they actually take their pills this means that they will not benefit from the treatment given and their symptoms will not go way.
Weakness - Rosa et al
Found 50% compliance between patients taking their medication and not taking it. This shows high rates of patients not taking their medication and as a result is a waste of recourses and its not actually helping them treated their symptoms/co-morbid factors.
