Eating Disorders - Treatment for Anorexia

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Doctors hoped that SSRIs could help prevent relapse in patients who have successfully restored their body weight. However, an important 2006 study in the Journal of the American Medical Association found that the SSRI fluoxetine (Prozac) does not provide any benefits for patients after weight restoration. In the study, there was no difference in the time to relapse between patients who received fluoxetine and those who received placebo. The researchers concluded patients with anorexia nervosa derive little benefit from antidepressant treatment, either when they are underweight or after weight restoration. The researchers recommended that more efforts be placed on psychological and behavioral interventions rather than antidepressant drug treatment.

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Anti-Anxiety Drugs. Patients with anxiety disorders and anorexia may benefit from drugs that treat anxiety. [See In-Depth Report #28: Anxiety.]

Atypical Antipsychotics. Certain drugs, called atypical antipsychotics, are currently used for schizophrenia and bipolar disorders. Not only are they useful for stabilizing mood but they also produce significant weight gain. Specific drugs that may be helpful for patients with severe treatment-resistant anorexia include olanzapine (Zyprexa).

Drugs and Supplements to Restore Hormonal Function and Bone Density

Oral Contraceptives. Although abnormal reproductive hormone balances appear to be more important in bone loss than low weight, the use of oral contraceptives (OCs), which contain estrogen and progestin, have had mixed results, with many showing no improvement. Still, it is important to try to restore normal menstruation in women with anorexia nervosa.

Calcium and Vitamin D. Patients should take supplements of 1,000 - 1,500 mg of calcium and a multivitamin containing 400 IU of vitamin D.