J. Clin. Med. 2019, 8(2), 278; https://doi.org/10.3390/jcm8020278
Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews
Corinne Blanchet 1,2,3, Sébastien Guillaume 3,4,5, Flora Bat-Pitault 3,6,7, Marie-Emilie Carles 1, Julia Clarke 3,8,9, Vincent Dodin 3,10,11, Philibert Duriez 3,9,12
, Priscille Gerardin 3,13,14, Mouna Hanachi-Guidoum 3,15,16, Sylvain Iceta 3,17,18, Juliane Leger 19,20,21, Bérénice Segrestin 3,17,22, Chantal Stheneur 3,23,24 and Nathalie Godart 3,16,25,26,*
, Priscille Gerardin 3,13,14, Mouna Hanachi-Guidoum 3,15,16, Sylvain Iceta 3,17,18, Juliane Leger 19,20,21, Bérénice Segrestin 3,17,22, Chantal Stheneur 3,23,24 and Nathalie Godart 3,16,25,26,*
1
Maison de Solenn-Maison des Adolescents, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France
2
CESP, INSERM 1178, Paris-Descartes University, USPC, 75014 Paris, France
3
French Federation Anorexia Bulimia (FFAB), 75014 Paris, France
4
Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, 34090 Montpellier, France
5
INSERM U1061, University of Montpellier, 34090 Montpellier, France
6
Child and Adolescent Psychopathology Unit, Salvator Hospital, Public Assistance-Marseille Hospitals, 13009 Marseille, France
7
Institut de la Timone, CNRS, Aix-Marseille University, 13005 Marseille, France
8
Child and Adolescent Psychiatry Department, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France
9
INSERM U894, Institute of Psychiatry and Neuroscience of Paris (IPNP), 75013 Paris, France
10
Clinique Médico-Psychologique, Neurosciences Hôpital Saint Vincent de Paul, 59000 Lille, France
11
Faculté de Médecine et de Maïeutique de Lille, 59800 Lille, France
12
Sainte-Anne Hospital (CMME), Paris Descartes University, 75014 Paris, France
13
Pôle universitaire de psychiatrie de l’enfant et de l’adolescent CH du Rouvray-CHU de Rouen, 76300 Rouen, France
14
CRFDP, UFR des Sciences de l’Homme et de la Société, Rouen University, 76130 Mont-Saint-Aignan, France
15
Clinical Nutrition Unit, Raymond Poincaré University Hospital, Assistance Publique-Hôpitaux de Paris, 92380 Garches, France
16
CESP, INSERM, UMR 1018, University Paris-Sud, UVSQ, University Paris-Saclay, 94800 Villejuif, France
17
Referral Center for Eating Disorder, Hospices Civils de Lyon, 69677 Bron, France
18
Equipe PSYR2, INSERM U1028, CNRS UMR5292, Université Lyon 1, 69002 Lyon, France
19
Pediatric Endocrinology Diabetology Department, Reference Centre for Endocrine Growth and Development Diseases, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, 75019 Paris, France
20
Paris Diderot University, Sorbonne Paris Cité, F-75019 Paris, France
21
Institut National de la Santé et de la Recherche Médicale (INSERM), UMR 1141, DHU Protect, F-75019 Paris, France
22
INSERM 1060, Laboratoire CARMEN, Centre de Recherche en Nutrition Humaine Rhône-Alpes, Claude Bernard University, Lyon 1, Pierre Bénite, 69310 Lyon, France
23
Centre Médical et Pédagogique, Fondation Santé des Etudiants de France, 91480 Varennes Jarcy, France
24
Faculté de Médecine, Université de Montréal, Quebec, QC H3C 3J7, Canada
25
Adolescent and Young Adult mental health department, Fondation Santé des Etudiants de France, 75014 Paris, France
26
UFR Simone Veil-Santé, 78690 Saint-Quentin en Yvelines, France
*
Author to whom correspondence should be addressed.
Received: 15 January 2019 / Revised: 19 February 2019 / Accepted: 20 February 2019 / Published: 25 February 2019
(This article belongs to the Special Issue Anorexia Nervosa)
Abstract
Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication (psychotropic drugs and medication for somatic and nutritional complications) in the field of anorexia nervosa since the 1960s, (2) to draw practical conclusions for everyday practise and future research. Searches were performed on three online databases, namely MEDLINE, Epistemonikos and Web of Science. Papers published between September 2011 and January 2019 were considered. Evidence-based data were identified from meta-analyses, if there were none, from systematic reviews, and otherwise from trials (randomized or if not open-label studies). Evidence-based results are scarce. No psychotropic medication has proved efficacious in terms of weight gain, and there is only weak data suggesting it can alleviate certain psychiatric symptoms. Concerning nutritional and somatic conditions, while there is no specific, approved medication, it seems essential not to neglect the interest of innovative therapeutic strategies to treat multi-organic comorbidities. In the final section we discuss how to use these medications in the overall approach to the treatment of anorexia nervosa. View Full-TextKeywords:
anorexia nervosa; drug-treatment; pharmacotherapy; medication; nutrition; comorbidity; complication
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Blanchet, C.; Guillaume, S.; Bat-Pitault, F.; Carles, M.-E.; Clarke, J.; Dodin, V.; Duriez, P.; Gerardin, P.; Hanachi-Guidoum, M.; Iceta, S.; Leger, J.; Segrestin, B.; Stheneur, C.; Godart, N. Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews. J. Clin. Med. 2019, 8, 278.
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