世界生物精神病学协会联合会（WFSBP）2023年饮食失调药物治疗指南更新
World Federation of Societies of Biological Psychiatry (WFSBP) guidelines update 2023 on the pharmacological treatment of eating disorders.
作者信息
Himmerich Hubertus, Lewis Yael Doreen, Conti Chiara, Mutwalli Hiba, Karwautz Andreas, Sjögren Jan Magnus, Uribe Isaza María Mercedes, Tyszkiewicz-Nwafor Marta, Aigner Martin, McElroy Susan L, Treasure Janet, Kasper Siegfried
机构信息
Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.
出版信息
World J Biol Psychiatry. 2023 Apr 24:1-64. doi: 10.1080/15622975.2023.2179663.
OBJECTIVES
This 2023 update of the WFSBP guidelines for the pharmacological treatment of eating disorders (EDs) reflects the latest diagnostic and psychopharmacological progress and the improved WFSBP recommendations for the assessment of the level of evidence (LoE) and the grade of recommendation (GoR).
METHODS
The WFSBP Task Force EDs reviewed the relevant literature and provided a timely grading of the LoE and the GoR.
RESULTS
In anorexia nervosa (AN), only a limited recommendation (LoE: A; GoR: 2) for olanzapine can be given, because the available evidence is restricted to weight gain, and its effect on psychopathology is less clear. In bulimia nervosa (BN), the current literature prompts a recommendation for fluoxetine (LoE: A; GoR: 1) or topiramate (LoE: A; GoR: 1). In binge-eating disorder (BED), lisdexamfetamine (LDX; LoE: A; GoR: 1) or topiramate (LoE: A; GoR: 1) can be recommended. There is only sparse evidence for the drug treatment of avoidant restrictive food intake disorder (ARFID), pica, and rumination disorder (RD).
CONCLUSION
In BN, fluoxetine, and topiramate, and in BED, LDX and topiramate can be recommended. Despite the published evidence, olanzapine and topiramate have not received marketing authorisation for use in EDs from any medicine regulatory agency.
目标
世界生物精神病学协会联合会（WFSBP）饮食失调（EDs）药物治疗指南的这份2023年更新版反映了最新的诊断和精神药理学进展，以及WFSBP对证据水平（LoE）评估和推荐等级（GoR）的改进建议。
方法
WFSBP饮食失调特别工作组回顾了相关文献，并及时对证据水平和推荐等级进行了分级。
结果
在神经性厌食症（AN）中，仅能对奥氮平给出有限推荐（证据水平：A；推荐等级：2），因为现有证据仅限于体重增加，其对精神病理学的影响尚不清楚。在神经性贪食症（BN）中，当前文献提示推荐使用氟西汀（证据水平：A；推荐等级：1）或托吡酯（证据水平：A；推荐等级：1）。在暴饮暴食症（BED）中，可以推荐赖氨酸右旋苯丙胺（LDX；证据水平：A；推荐等级：1）或托吡酯（证据水平：A；推荐等级：1）。关于回避性限制性食物摄入障碍（ARFID）、异食癖和反刍障碍（RD）的药物治疗仅有少量证据。
结论
在BN中，可推荐氟西汀和托吡酯，在BED中，可推荐LDX和托吡酯。尽管有已发表的证据，但奥氮平和托吡酯尚未获得任何药品监管机构批准用于EDs的上市许可。
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