TY - CHAP M1 - Book, Section TI - Eating Disorders A1 - Stoner, Steven C. A1 - Ruehter, Valerie L. A1 - Palmer, Melissa C. A2 - DiPiro, Joseph T. A2 - Yee, Gary C. A2 - Posey, L. Michael A2 - Haines, Stuart T. A2 - Nolin, Thomas D. A2 - Ellingrod, Vicki PY - 2020 T2 - Pharmacotherapy: A Pathophysiologic Approach, 11e AB - KEY CONCEPTS Historically, the categorization of eating disorders as a psychiatric illness has faced significant scrutiny, while no longer the case the treatments of these disorders continue to be challenging with limited evidence-based medicine–supported treatments. Despite strong genetic associations for the development of eating disorders as established in monozygotic and dizygotic twin studies, a clear association with a specific genetic linkage or mutation has not been identified. Shifting between eating disorder diagnostic categories is possible, especially when symptom remission is not achieved with treatment. Psychiatric comorbidities are common with all forms of eating disorders, and the differential diagnosis should generally include evaluation for depression, schizophrenia, generalized anxiety, obsessive–compulsive disorder (OCD), and personality disorders. During the process of caloric restoration, calories must be gradually introduced to prevent the potentially fatal complication known as refeeding syndrome. Failure to restore calories quickly enough may result in an unfeeding syndrome. Mortality resulting from suicide in individuals with eating disorders is not uncommon, and clinicians must monitor closely for suicidality and educate appropriately as they would during the treatment of patients with major depressive disorder taking antidepressants. The current preferred treatment approach for anorexia nervosa (AN) includes a minimum of 6 months of psychotherapy, preferably cognitive behavioral therapy (CBT), in adults and family-based therapy in children. Despite limited data, antidepressants are the preferred pharmacologic intervention for the acute and maintenance phases of bulimia nervosa (BN) in combination with nonpharmacologic treatments. A growing body of evidence supports the use of selective serotonin reuptake inhibitors (SSRIs) for the treatment of binge-eating disorder (BED) along with CBT and interpersonal psychotherapy (IPT). Lisdexamfetamine is the sole FDA-approved agent for BED treatment. There is growing sentiment that severe and enduring AN exists and that the focus should be on the impact of the disorder and improving quality of life instead of on treating medical symptoms. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1182456813 ER -