The role of psychopharmacotherapy in the treatment of eating disorders

Eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN) and binge-eating disorder (BED), are psychiatric conditions complicated by multiple medical dysfunctions, which may actually threat the patient's life. The therapy of EDs is multidisciplinary, since it encompasses nutritional and medical interventions as well as psychotherapeutic and psychopharmacological treatments. As for psychopharmacotherapy, virtually every class of psychotropic medications has been tested in the treatment of these disorders. Controlled and uncontrolled studies testing antipsychotic, antidepressant, anticonvulsant, appetite-regulating drugs have demonstrated that core symptoms of AN are refractory to current available psychotropic medications. Placebo-controlled studies with antidepressants have been far more promising for treating BN and BED in the short term. The increasing evidence for the role of biological factors in the etiopathogenesis of EDs should encourage investigators to perform adequately powered clinical trials especially on "new generation" agents, which will become available as far as pathophysiological aspects of EDs will be more deeply known. © 2007 Giovanni Fioriti Editore s.r.l.