Pharmacotherapy and Physiological Intervention for Eating Disorders

Pharmacotherapy is not an exclusive treatment for anorexia nervosa (AN) or the first recommended therapy for bulimia nervosa (BN) or binge eating disorder (BED). Limited randomized controlled trials (RCTs) indicate a very modest benefit for zinc supplementation and a greater effect of olanzapine (if ingested) in treating AN. Fluoxetine is the only FDA approved drug for treating BN and has the best side effect profile compared with imipramine, desipramine, sertraline, fluvoxamine, and topiramate, all of which were more effective than placebo in reducing binge eating in BN. RCTs with BED indicate that citalopram and sertraline are effective with the best risk benefit ratio, followed by imipramine and topiramate. The latter drug has the benefit of inducing weight loss. No studies are available for information on optimal duration of any drug administration for treating AN, BN, or BED.