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饮食失调人群的处方药和非处方药使用情况

Prescription and Nonprescription Drug Use Among People With Eating Disorders.

作者信息

Rodan Sarah-Catherine, Maguire Sarah, Meez Noah, Greenstien Kayla, Zartarian Garen, Mills Katherine L, Suraev Anastasia, Bedoya-Pérez Miguel A, McGregor Iain S

机构信息

Lambert Initiative for Cannabinoid Therapeutics, Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.

School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

JAMA Netw Open. 2025 Jul 1;8(7):e2522406. doi: 10.1001/jamanetworkopen.2025.22406.


DOI:10.1001/jamanetworkopen.2025.22406
PMID:40694346
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12284744/
Abstract

IMPORTANCE: There are few effective pharmacotherapies for treating eating disorders (EDs). High rates of substance use among individuals with EDs suggest potential self-medication of symptoms. OBJECTIVE: To explore the experiences of individuals with EDs regarding use of prescribed and nonprescribed drugs. DESIGN, SETTING, AND PARTICIPANTS: This survey study assessed responses to the Medications and Other Drugs for Eating Disorders (MED-FED) survey, which was advertised internationally using social media, online forums, and clinical services and recruited adults who self-reported an ED or disordered eating from November 10, 2022, to May 31, 2023. The online survey queried about recent prescribed and nonprescribed drug use as well as the perceived benefits and harms of each substance. EXPOSURES: EDs or disordered eating and co-occurring mental health conditions. Substances evaluated included caffeine, alcohol, nicotine, cannabis, prescription psychotropics, psychedelics, ketamine, 3,4-methylenedioxymethamphetamine (or ecstasy), stimulants, opioids, and other drugs. MAIN OUTCOMES AND MEASURES: Respondents described drug use over the past 12 months. For each drug used, they rated their agreement or disagreement on a 5-point Likert scale (-2, strongly disagree; -1, disagree; 0, neutral; 1, agree; or 2, strongly agree) with the following 3 statements: (1) this medication/drug makes my eating disorder symptoms better; (2) this medication/drug has overall benefits for my mental health; and (3) this medication/drug has unpleasant side effects. RESULTS: There were 7648 participants recruited, of whom 6612 completed the demographic portion, and 5123 completed the entire survey. Among the 6612 respondents (mean [SD] age, 24.3 [7.7] years), the sample was predominantly female (6217 [94.0%]), and most resided in Australia (1981 [30.0%]), the UK (1409 [21.3%]), or the US (1195 [18.0%]). Diagnosed EDs included 2696 (40.8%) individuals with anorexia nervosa, 1258 (19.0%) with bulimia nervosa, 757 (11.4%) with binge-eating disorder, and 589 (8.9%) with avoidant/restrictive food intake disorder. Many respondents (2493 [37.7%]) were undiagnosed. Psychiatric comorbidities were highly prevalent; depression was reported by 4333 respondents (65.5%). Cannabis and psychedelics were highest-rated for improving ED symptoms. Prescription antidepressants were rated highly for overall mental health but not for ED symptoms, with the exception of fluoxetine for bulimia nervosa and lisdexamfetamine for binge-eating disorder. Alcohol, nicotine, and tobacco were rated as the most harmful drugs. CONCLUSIONS AND RELEVANCE: The findings of this survey study of prescription and nonprescription drug use suggest that cannabis and psychedelics were perceived by survey respondents as efficacious in alleviating their ED symptoms, which supports further research in this area. Prescription psychotropics were perceived as being relatively ineffective for ED symptoms but beneficial to general mental health.

摘要

重要性:治疗饮食失调(EDs)的有效药物疗法很少。饮食失调患者中物质使用的高发生率表明可能存在对症状的自我药物治疗。 目的:探讨饮食失调患者使用处方药和非处方药的经历。 设计、背景和参与者:这项调查研究评估了对饮食失调药物及其他药物(MED-FED)调查的回应,该调查通过社交媒体、在线论坛和临床服务在国际上进行宣传,并招募了在2022年11月10日至2023年5月31日期间自我报告患有饮食失调或饮食紊乱的成年人。在线调查询问了近期的处方药和非处方药使用情况以及每种物质的感知益处和危害。 暴露因素:饮食失调或饮食紊乱以及共病的心理健康状况。评估的物质包括咖啡因、酒精、尼古丁、大麻、处方精神药物、致幻剂、氯胺酮、3,4-亚甲基二氧基甲基苯丙胺(或摇头丸)、兴奋剂、阿片类药物和其他药物。 主要结局和指标:受访者描述了过去12个月的药物使用情况。对于每种使用的药物,他们在5点李克特量表(-2,强烈不同意;-1,不同意;0,中立;1,同意;或2,强烈同意)上对以下3个陈述表示同意或不同意:(1)这种药物使我的饮食失调症状好转;(2)这种药物对我的心理健康有总体益处;(3)这种药物有令人不快的副作用。 结果:共招募了7648名参与者,其中6612人完成了人口统计学部分,5123人完成了整个调查。在6612名受访者中(平均[标准差]年龄,24.3[7.7]岁),样本主要为女性(6217[94.0%]),大多数居住在澳大利亚(1981[30.0%])、英国(1409[21.3%])或美国(1195[18.0%])。诊断出的饮食失调包括2696名(40.8%)神经性厌食症患者、1258名(19.0%)神经性贪食症患者、757名(11.4%)暴饮暴食症患者和589名(8.9%)回避/限制性食物摄入障碍患者。许多受访者(2493[37.7%])未被诊断。精神共病非常普遍;4333名受访者(65.5%)报告有抑郁症。大麻和致幻剂在改善饮食失调症状方面的评分最高。处方抗抑郁药在总体心理健康方面评分较高,但对饮食失调症状评分不高,除了氟西汀对神经性贪食症和赖右苯丙胺对暴饮暴食症。酒精、尼古丁和烟草被评为最有害的药物。 结论和相关性:这项关于处方药和非处方药使用的调查研究结果表明,调查受访者认为大麻和致幻剂在缓解他们的饮食失调症状方面有效,这支持了在该领域的进一步研究。处方精神药物被认为对饮食失调症状相对无效,但对总体心理健康有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/abad63e71933/jamanetwopen-e2522406-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/aef6b9e5b816/jamanetwopen-e2522406-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/f735e3a47ad1/jamanetwopen-e2522406-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/398d5bf73e09/jamanetwopen-e2522406-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/abad63e71933/jamanetwopen-e2522406-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/aef6b9e5b816/jamanetwopen-e2522406-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/f735e3a47ad1/jamanetwopen-e2522406-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/398d5bf73e09/jamanetwopen-e2522406-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0533/12284744/abad63e71933/jamanetwopen-e2522406-g004.jpg

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引用本文的文献

[1]
Psychedelic use in individuals living with eating disorders or disordered eating: findings from the international MED-FED survey.

J Eat Disord. 2025-7-24

本文引用的文献

[1]
Eating Disorders: A Review.

JAMA. 2025-4-8

[2]
Psychiatric medication use by Canadian adults prior to entering an outpatient eating disorders program: Types and combinations of medications, predictors of being on a medication, and clinical considerations.

Psychiatry Res. 2022-11

[3]
Psilocybin therapy for females with anorexia nervosa: a phase 1, open-label feasibility study.

Nat Med. 2023-8

[4]
Pharmacotherapy, alternative and adjunctive therapies for eating disorders: findings from a rapid review.

J Eat Disord. 2023-7-6

[5]
Eating disorders and substance use: Examining associations among US college students.

Int J Eat Disord. 2023-5

[6]
Ketogenic diet and ketamine infusion treatment to target chronic persistent eating disorder psychopathology in anorexia nervosa: a pilot study.

Eat Weight Disord. 2022-12

[7]
Screening, assessment and diagnosis in the eating disorders: findings from a rapid review.

J Eat Disord. 2022-6-7

[8]
Food addiction and lifetime alcohol and illicit drugs use in specific eating disorders.

J Behav Addict. 2022-3-28

[9]
A longitudinal case series of IM ketamine for patients with severe and enduring eating disorders and comorbid treatment-resistant depression.

Clin Case Rep. 2021-4-4

[10]
Atypical Antipsychotics and Metabolic Syndrome: From Molecular Mechanisms to Clinical Differences.

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