Goldbloom D S, Kennedy S H, Kaplan A S, Woodside D B
Department of Psychiatry, Toronto General Hospital, Ont.
CMAJ. 1989 May 15;140(10):1149-54.
No definitive therapy exists for anorexia nervosa (AN) or bulimia nervosa (BN). Nevertheless, biologic and psychologic research into these disorders has increased over the last decade. We examine the various drugs available for treatment. Advances in pharmacotherapy for AN have been modest and have reflected efforts either to stimulate hunger and weight gain or to control complications of the starvation process. Food remains the "drug" of choice. Antidepressants have been found to be beneficial in the treatment of BN. The meaning of this in the context of a relation between BN and mood disorders remains unclear, since coexistent depression does not predict a positive response to these drugs. Pharmacotherapy represents a single but important dimension of the management of patients with eating disorders. The optimal integration of drug therapy and psychotherapy and the identification of predictors of a positive response to drugs have yet to be addressed by clinical research.
神经性厌食症(AN)或神经性贪食症(BN)尚无确切的治疗方法。然而,在过去十年中,针对这些疾病的生物学和心理学研究有所增加。我们研究了各种可用于治疗的药物。AN药物治疗的进展不大,主要体现在刺激食欲和体重增加或控制饥饿过程并发症的努力上。食物仍然是首选的“药物”。已发现抗抑郁药对BN的治疗有益。鉴于BN与情绪障碍之间的关系,这一发现的意义尚不清楚,因为并存的抑郁症并不能预测对这些药物的积极反应。药物治疗是饮食失调患者管理中的一个重要但单一的维度。药物治疗和心理治疗的最佳整合以及对药物积极反应预测因素的识别仍有待临床研究解决。