The Use of Psychiatric Medications in Anorexia Nervosa

Dr. David Herzog, Emeritus Professor of Psychiatry at Harvard Medical School, has collaborated with the Neuroendocrine Unit at Massachusetts General Hospital for over 25 years to better understand the hormonal factors that contribute to anorexia nervosa and the interventions that influence the course of the illness.  Many of these studies have tested effective treatments for complications such as bone loss, anxiety and depression.  Recently, Dr. Herzog and the team investigated the use of antidepressants, particularly SSRIs (selective serotonin reuptake inhibitors), and atypical antipsychotics from 1997 to 2009 in women with anorexia nervosa.

525 participants were identified through the Neuroendocrine Unit’s research database and included in the analysis. To investigate changes in medication between 1997 and 2009, the scientists divided the women into two groups based on their date of presentation. Group I consisted of the 325 subjects who were screened between 1997 and 2002, and Group II consisted of the 200 participants screened between 2003 and 2009.  All subjects had a complete medical history and physical exam.  

Overall, 53% of the participants reported current use of any psychiatric medication. 48.4% reported use of an antidepressant and 13% reported use of an antipsychotic. The use of antidepressants remained stable between 1997 and 2009 but the rate of atypical antipsychotic use doubled over this time period.  These findings are concerning because antidepressants and atypical antipsychotics have not been shown to be effective in anorexia nervosa and may have significant negative impact on the bone health of this population.  Longer-term studies are necessary to evaluate the effectiveness and benefits of these medications before their widespread use continues.