Antidepressants are used to treat
comorbid symptoms of anorexia,
such as depression. This is done
because they reduce the reuptake
of serotonin and/or noradrenaline at
the synapse.
As they leave more serotonin at
the synapse to bind with
receptors, it reduces
depression. However, it also
increases the individual's
appetite as serotonin is linked
to appetite levels.
These drugs can have a side effect of weight gain because of the
increased appetite. Therefore, they are not suitable for everyone
as it could potentially trigger more issues if an individual starts to
gain weight. Because of this, antidepressants are usually only
given to those who are already recovering and gaining weight on
their own. Furthermore, drug treatment is used cautiously for
under 18s, which may be an issue as a lot of people with anorexia
are teenagers and under 18.
Ferguson compared 24 patients taking
antidepressants to 16 patients taking no drugs.
Results showed that there was no significant
difference on their clinical symptoms or reports
of anxiety. This suggests that antidepressants
may not be all that effective in treating anorexia.
However, other studies done by individuals
such as Kaye and Crisp found that different
antidepressants were effective at producing
significant weight gain in patients as well as
lower relapse rates and a reduction in other
symptoms.
Antipsychotics
Antipsychotics block post synaptic
dopamine receptors without
activating them. This reduces the
overall activity of the dopamine
system. This is useful as dopamine
levels are thought to be high in
anorexia patients.
They are thought to help counter the
distorted cognitions and views that
individuals with anorexia experience
in terms of their body weight (similar
to delusions in schizophrenia). They
also counter the reduced appetite.
Powers found that the use of antipsychotics to
treat anorexia patients was inconsistent - 10
individuals gained weight, 4 individuals failed to
complete the study, and 4 lost weight. This
suggests that they may not be the most effective
way of treating anorexia.
However, Court found psychological and physical
improvements in 33 patients with few side effects
when using antipsychotics, and Trunke found there
were 'promising' results when antipsychotics were
used for more than 4 months by 5 patients. These
studies refute Powers' study and suggests that
antipsychotics are effective in treating anorexia.
However, small sample sizes are often
used in these studies into drugs, as shown
in Trunke's study, which makes the results
hard to generalise - therefore we cannot
conclusively say whether drugs are largely
effective treatments for anorexia.
Drug treatments only deal with symptoms and do not treat the
underlying cause of the problem. The lack of understanding
surrounding what causes anorexia makes this issue a hard one
to fix. However, NICE guidelines do not recommend that this
treatment is the first option and therefore drug treatment
would likely be used in conjunction with other therapies that
may explore direct causes in that individual's life.
Drug treatment is often cheaper than other forms of
therapy, and keeps people out of hospitals, freeing up
resources and staff for other issues. However, some may
argue that this turns a blind eye to the problem, and
may make people feel forced into medication when they
believe that hospitalisation would be better for them
treatment wise.
As medication is self administered, there is no way to ensure that
the individual is taking the drugs. This may become a particular
issue if they gain weight as a side effect as this may be hard for
an individual dealing with anorexia to cope with. This could
impact the effectiveness of the treatment. However, this also
may give the individual a sense of control, which could be
beneficial as anorexia often makes the individual feel as though
they have a lack of control and this is what feeds the disorder.