Drug therapy can complement psychotherapy in specific situations, although it is not typically the primary treatment for eating disorders.
In cases of Anorexia Nervosa, antidepressants, particularly serotonin reuptake inhibitors (SSRIs), are used to address co-occurring depressive and obsessive-compulsive symptoms. However, these medications do not improve weight restoration or directly treat symptoms specific to the eating disorder.
It is important to note that depressive and obsessive-compulsive symptoms often result from low body weight rather than being independent conditions. Additionally, the use of antidepressants requires careful monitoring due to potential cardiac side effects and electrolyte imbalances, which are common in patients with Anorexia Nervosa. Neuroleptics, while less commonly used, have been studied to a limited extent. There is some evidence suggesting that they may reduce intrusive thoughts, weight-related anxiety, and hyperactivity, but their efficacy in treating anorexia remains inconclusive.
For patients with Bulimia Nervosa, antidepressants are more commonly prescribed due to the high prevalence of co-occurring depression. Beyond their antidepressant effects, these medications have been shown to positively influence bulimic behaviors. Among antidepressants, Fluoxetine (60 mg daily) is the most well-studied and widely approved treatment for Bulimia Nervosa. It has demonstrated efficacy in reducing binge-purge cycles and improving overall symptoms.
Currently, no medications have been specifically approved for the pharmacological treatment of binge eating disorder (BED). In some cases, antidepressants, including serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), may have a positive effect on mood, which can indirectly benefit individuals with BED. However, these medications do not appear to influence weight management or directly address the behaviors associated with the disorder. Appetite suppressants have not gained traction as a treatment option due to their side effects and limited efficacy in managing binge eating behaviors.