Steffen Kristine J, Roerig James L, Mitchell James E, Uppala Saritha
The Neuropsychiatric Research Institute, 120 8th Street South, PO Box 1415, Fargo, ND 58107, USA.
Expert Opin Emerg Drugs. 2006 May;11(2):315-36. doi: 10.1517/14728214.11.2.315.
Anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) comprise the currently recognised eating disorders. Although distinct diagnostic entities, they share certain forms of comorbid psychopathology, particularly anxiety and mood disorders. BN and BED have been studied most intensively as targets for pharmacotherapy. The list of drugs tested in eating disorders is substantial; however, the number of therapeutic classes of medications tested in these conditions is relatively modest. Antidepressant medications, including tricyclic antidepressants, selective serotonin re-uptake inhibitors, as well as some of the novel antidepressants, have shown evidence of some therapeutic value in both BN and BED. Their efficacy in AN, however, has been disappointing. The pharmacological options for AN are very limited. The number of controlled trials that have been conducted is small, and the research that has been successfully completed has generally failed to demonstrate medication efficacy. Patients with BN typically show reduced binge eating and purging frequency in medication trials, but rarely attain abstinence. In BED, patients often measure the value of their medication therapy by its ability to stimulate weight loss, which is another area on which future pharmacotherapy may improve. Novel pharmacological interventions are needed for each of these conditions. Peptide hormones are increasingly being evaluated for eating disorder treatment, including ghrelin agonists, neuropeptide Y1 and -5 antagonists, orexin receptor antagonists, corticotropin-releasing factor receptor 2 antagonists, histamine 3 antagonists, melanocortin 4 receptor antagonists, beta3-adrenoceptor agonists, 5-hydroxytryptamine-2A antagonists and growth hormone agonists. Although these compounds are in early phases of clinical testing for eating disorder treatments, data from these studies will be instructive in the quest for effective pharmacotherapy for these conditions. An overview of the current pharmacotherapy options for eating disorders is presented with a discussion of the emerging potential treatments.
神经性厌食症（AN）、神经性贪食症（BN）和暴饮暴食症（BED）构成了目前公认的饮食失调症。尽管它们是不同的诊断实体，但它们有某些形式的共病精神病理学，特别是焦虑症和情绪障碍。BN和BED作为药物治疗的靶点受到了最深入的研究。在饮食失调症中测试的药物种类繁多；然而，在这些病症中测试的药物治疗类别数量相对较少。抗抑郁药物，包括三环类抗抑郁药、选择性5-羟色胺再摄取抑制剂以及一些新型抗抑郁药，已显示出在BN和BED中具有一定治疗价值的证据。然而，它们在AN中的疗效却令人失望。AN的药物治疗选择非常有限。已进行的对照试验数量很少，并且已成功完成的研究通常未能证明药物的疗效。在药物试验中，BN患者通常表现出暴饮暴食和清除频率降低，但很少能达到戒除。在BED中，患者常常根据药物治疗刺激体重减轻的能力来衡量其价值，这是未来药物治疗可能改善的另一个领域。这些病症中的每一种都需要新的药物干预措施。肽类激素越来越多地被评估用于饮食失调症的治疗，包括胃饥饿素激动剂、神经肽Y1和Y5拮抗剂、食欲素受体拮抗剂、促肾上腺皮质激素释放因子受体2拮抗剂、组胺3拮抗剂、黑皮质素4受体拮抗剂、β3肾上腺素能受体激动剂、5-羟色胺-2A拮抗剂和生长激素激动剂。尽管这些化合物处于饮食失调症治疗的临床测试早期阶段，但这些研究的数据将有助于寻找针对这些病症的有效药物治疗方法。本文概述了饮食失调症目前的药物治疗选择，并讨论了新兴的潜在治疗方法。
