Kracke Elsa J, Tosh Aneesh K
University of Missouri School of Medicine, One Hospital Drive, MA204, DC018.00, Columbia, MO 65212 USA.
University of Missouri Department of Child Health, 400 N. Keene Street, Columbia, MO 65201 USA.
Springerplus. 2014 Dec 2;3:706. doi: 10.1186/2193-1801-3-706. eCollection 2014.
There are currently few studies focusing on the efficacy of long-term atypical antipsychotics to treat anorexia nervosa in the pediatric population.
This case report follows the treatment of a 17 year-old female with anorexia nervosa over her four-year undergraduate career. After two years of multidisciplinary treatment, low-dose risperidone was initiated due to persistence of her disease. She expressed decreased rigidity around meal times, her weight improved and she had resumption of menses. She was compliant with treatment through graduation and maintained her weight gain.
DISCUSSION & EVALUATION: Atypical antipsychotics are a treatment option in the management of anorexia nervosa. Risperidone has not been studied as frequently as olanzapine for eating disorders. Risperidone was chosen for its more favorable side effect profile and decreased cost to the patient. Previous studies on anorexia nervosa treatment have occurred during inpatient treatment and have limited follow-up due to patients' refusal to initiate or maintain medication compliance. This case presents 17 months of outpatient data. The efficacy of risperidone therapy was evaluated with frequent weight checks, subjective decrease in rigidity, serial complete metabolic panels, and restoration of menses.
In this case report, an adolescent female treated with low-dose risperidone had decreased rigid thinking, weight gain and resolution of secondary amenorrhea without medication side effects. Therefore, the atypical antipsychotic risperidone may be an effective long-term outpatient treatment option for patients with anorexia nervosa.
目前很少有研究关注长效非典型抗精神病药物治疗儿科人群神经性厌食症的疗效。
本病例报告追踪了一名17岁神经性厌食症女性患者在其四年本科学习生涯中的治疗情况。经过两年的多学科治疗后，由于病情持续，开始使用低剂量利培酮治疗。她表示用餐时的强迫观念有所减轻，体重增加，月经恢复。她在毕业前一直坚持治疗，并维持了体重增长。
非典型抗精神病药物是治疗神经性厌食症的一种选择。与奥氮平相比，针对饮食失调使用利培酮进行研究的频率较低。选择利培酮是因其副作用较小且患者费用较低。以往关于神经性厌食症治疗的研究多在住院治疗期间进行，且由于患者拒绝开始或维持药物治疗依从性，随访有限。本病例提供了17个月的门诊数据。通过频繁的体重检查、主观强迫观念减轻、系列完整代谢指标检查以及月经恢复来评估利培酮治疗的疗效。
在本病例报告中，一名接受低剂量利培酮治疗的青春期女性思维强迫观念减轻、体重增加且继发性闭经得到缓解，且无药物副作用。因此，非典型抗精神病药物利培酮可能是神经性厌食症患者有效的长期门诊治疗选择。
