The Effects of Pharmacological Treatment on Anorexia Nervosa
The Characteristics of Anorexia Nervosa
Individuals with anorexia nervosa are so successful at losing weight that they put their lives in a great deal of danger. Although dramatic weight loss is the most noticeable feature of the disease, anorexics also have an intense fear of obesity and pursue thinness with unparallelled ambition (Bruch, 1986). Anorexia is most common among females, with only about five percent of those suffering from the disease being male. It is also most likely to develop in young females as a result of societal pressures on women to remain slim. The DSM-4 criteria for anorexia nervosa contains the following factors : maintenance of a body weight which is less than 85% of that expected for normal weighing individuals, intense fear of becoming overweight, disturbance or distortion of how one views their own body weight or shape, and the absence of at least three consecutive menstrual cycles. The Diagnostic and Statistical Manual specifies two types of anorexia : restricting type and binge-eating-purging type. The restricting type refers to those who do not regularly binge eat or purge, while the binge-eating-purging type refers to those who regularly engage in binge eating and purging behavior during an episode of anorexia. Anorexia nervosa is very difficult to treat due to the misconceptions in the minds of the afflicted individuals. While psychosocial treatments have been proven to be helpful, very little evidence exists to suggest that pharmacological treatment could be effective.
The Effects of Antipsychotic Medication on the Treatment of Anorexia
The first attempts to use medicine in the treatment of anorexia nervosa were performed by Dally and Sargant (1966) and used the antipsychotic drug, chlorpromazine (http://pharminfo.com/pubs/msb/seroton.html). Although a significant number of patients treated with this drug gained weight faster and were discharged sooner than those who received no medication, the chlorpromazine treated patients were no better off than those who were not treated with medicine on the follow-up, suggesting no beneficial effects of this medication. Also, the side effects of chlorpromazine were horrific. A number of the patients developed very serious seizures, and almost half of them developed bulimia nervosa.
Vandereycken and Pierloot's (1982) study using pimozide was based on the finding that increased central dopaminergic activity might be a cause of anorexia. Although no change occurred in the patients' behavior or attitude, a very small, but significant, increase in the mean daily weight gain did occur. In 1984, Vandereycken followed up with a study on the antipsychotic drug, sulpiride. However, no statistically significant effects of sulpiride occurred on either the mean daily weight change or the behavioral and attitudinal characteristics of the patients.
Due to the inability to clearly determine if...