If your son or daughter is suffering from an eating disorder, such as anorexia nervosa, it’s helpful to know what will support his or her recovery. In the past, psychiatrists have prescribed antidepressants to help prevent relapse after a teen was hospitalized. However, research indicates that antidepressants are simply not effective for that reason.
Anorexia Nervosa is a psychological illness that is characterized by the control of food intake. Those with the illness tend to have many thought patterns, obsessions, beliefs, and ideas that feed the disorder. Part of treating the control of eating in teens and adults is the exploration of those thoughts and beliefs.
Various psychological treatment forms include individual therapy, group therapy, support groups, and psycho-educational groups, and medication, such as antidepressants. Certainly, antidepressants are used to treat not only moderate to severe depression, but also other psychological disorders such as anxiety disorders, such as Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD). Antidepressants can also address the painful mood states that some with personality disorders experience.
The National Institute of Mental Health (NIMH) funded a study to explore the effects of antidepressants on those with eating disorders. The study revealed that Prozac, the medication used in the research, was no more effective in preventing relapse among patients. The research specifically looked at those who had already achieved a healthy body weight as a result of participating in a residential treatment program and whether the medication worked to prevent a relapse.
After discharge from the treatment program, the participants of the study were given either Prozac or a placebo. The participants were also given 50 weeks of psychotherapy to also reduce the likelihood of relapse. After the psychotherapy and 52 weeks post discharge, there was little difference between participants who had taken Prozac and those who took the placebo. Of those in the placebo group, 45% of participants did not relapse. At the same time, of the Prozac group, 43% of participants did not relapse. Furthermore, there was another similarity between both groups. Of the placebo group, 26% of participants maintained a healthy body weight, and of the Prozac group, 31% maintained a healthy body weight.
There are a variety of antidepressants that are used for a different psychological disorders, depending upon which neurotransmitter they effect. For example, MAOI’s – Monoamine Oxidase Inhibitors were the first class of anti-depressants to be developed. They increase levels of norepinephrine, serotonin, and dopamine by inhibiting an enzyme called monoamine oxidase. TCA’s – Tricyclic Antidepressants work by increasing the levels of norepinephrine as well as serotonin, but to a lesser degree. SSRI’s – Selective Serotonin Re-uptake Inhibitors increase the levels of serotonin, which can ease depressive symptoms. SSRI’s are incredibly effective, but they do come with risks. For teens in particular, they can cause suicidal thoughts and even attempts at suicide. SNRI’s – Selective Serotonin Re-uptake Inhibitors are a new class of anti-depressants. They differ from SSRI’s in that they increase levels of both serotonin and norepinephrine in the brain. They have similar side effects to SSRI’s as well.
It’s frequently the case that teen eating disorders are accompanied by other illnesses, such as obsessive compulsive disorder, depression, and anxiety. And in these cases, treatment has included the use of antidepressants to help treat these disorders. However, this is precisely what makes this study significant. The study showed that antidepressant medication does not make a substantial difference in treatment for teen anorexia nervosa.
Of those teens who achieve a healthy body weight after initial hospitalization, 30% to 50% will experience a relapse and may need to be hospitalized again. However, the study also revealed that antidepressants do not make a significant impact in preventing relapse.
National Institute of Mental Health (June 2006). Antidepressant Does Not Reduce Risk Of Relapse Among Patients With Anorexia Nervosa. Retrieved on September 5, 2014 from: http://www.nimh.nih.gov/news/science-news/2006/antidepressant-does-not-reduce-risk-of-relapse-among-patients-with-anorexia-nervosa.shtml
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