Anorexia nervosa (AN) is a significant psychiatric illness associated with significant

Anorexia nervosa (AN) is a significant psychiatric illness associated with significant medical and psychiatric morbidity psychosocial impairment increased risk of death and chronicity. the evidence base is usually strongest for the use of family therapy over option individual psychotherapies. Results highlight difficulties in both treating individuals with AN and in studying the effects of those treatments and further emphasize the importance of continued efforts to develop novel interventions. Treatment trials currently underway and areas for future research are discussed. Keywords: anorexia nervosa treatment pharmacotherapy psychotherapy randomized controlled trials Introduction Anorexia nervosa (AN) is usually a serious psychiatric illness defined in the Diagnostic and Statistical Manual for Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) as a refusal to maintain minimally normal body weight an intense fear of gaining excess weight or becoming excess fat cognitive disturbances regarding one’s body weight and shape and amenorrhea in postmenarcheal females.1 AN has been associated with one of the highest rates of mortality among all psychiatric disorders 2 due to both medical complications and suicide.3 Given TMC353121 the severity of AN the establishment of both safe and effective treatments for the disorder is imperative. Pharmacologic and psychological treatments for AN have been designed to target the core features that define AN (excess weight appetite distorted thoughts and behaviors) as well as secondary symptoms such as depression and stress. Although a variety of treatments have been tried TMC353121 for AN few randomized controlled trials (RCTs) have been conducted and few favorable results have emerged. The aim of this paper is usually to review RCTs in AN to summarize the efficacy security and adherence associated with current treatments for AN. Methods Treatment trials were identified by electronic searches of the PubMed and PsychINFO databases from 1980 to May 2010 using the search terms “anorexia nervosa” “treatment” “pharmacology” “medication” “antidepressants” “antipsychotics” “psychotherapy” “cognitive behavioral therapy” “family therapy” “inpatient” and “hospitalization”. Given the current review’s focus on efficacy nonrandomized non-controlled treatment trials were excluded following review of abstracts and when necessary the articles. The reference sections of all articles were reviewed to identify additional studies. Information regarding treatment conditions length of treatment sample size proportion of female participants treatment adherence treatment end result and side effects or adverse outcomes were obtained from all articles (n = 33) that met the inclusion criteria. Table 1 summarizes the information for pharmacotherapy trials Table 2 for psychotherapy trials and Table 3 for trials comparing inpatient and outpatient treatment programs. No studies compared the efficacy of pharmacotherapy to psychotherapy and studies that TMC353121 examined the efficacy of medications added to psychotherapy are included in Table 1. Table 1 Randomized TMC353121 controlled medication trials in anorexia nervosa Table 2 Randomized controlled psychotherapy trials in anorexia nervosa Table 3 Randomized controlled hospitalization trials in anorexia nervosa Results Medication trials Several classes of medication have been examined in the treatment of AN. Evidence regarding the efficacy of pharmacotherapy for AN is limited and there are currently no medications for the treatment of AN that are approved by the US Food and Drug Administration. Antidepressants One of the most Pecam1 studied medication course for AN is antidepressants prominently. Antidepressants show efficiency in the treating many Axis I disorders including main despair obsessive compulsive disorder and bulimia nervosa (BN). Predicated on distributed features between AN and disorders that react favorably to treatment with antidepressants different classes of antidepressants including tricyclics (TCAs) and selective serotonin reuptake inhibitors (SSRIs) have already been evaluated in the treating AN. Efficiency Early antidepressant medication studies evaluated TCAs including amitriptyline and clomipramine. Generally the TCAs never have shown to be effective in dealing with the primary symptoms of the or concurrent despair. Two RCTs analyzing the influence of clomipramine (a serotonin.