The role of drug therapies in the treatment of anorexia and bulimia nervosa: A review of the literature

Background: The present review summarizes published papers reporting the results of both open-label and double-blind studies, which explored the potential efficacy of antidepressants, antipsychotics and mood stabilizers in the treatment of anorexia nervosa (AN) and bulimia nervosa (BN). Methods: The literature was sourced from recent searches on Pubmed updated to January 2013 using the terms "eating disorders", "pharmacotherapy", "anorexia nervosa", "bulimia nervosa", "therapy" or "treatment". Studies were selected for inclusion if they met a level of evidence that minimized the risk of bias such as randomized controlled trials (RCTs) or systematic review of RCTs. Results : This critical review seems to suggest that selective serotonin reuptake inhibitors (SSRI) have a proven efficacy in BN. Antipsychotics seem to be potentially promising options in the treatment of severe adult and adolescent AN patients, revealing positive psychopathological effects and good tolerability. Other treatments, such as the anticonvulsant topiramate in BN, may be promising. Conclusion: Even if there have been useful researches on the efficacy of pharmacotherapy in the treatment of BN, there are still many unsolved issues regarding the optimal management of other EDs. Future directions for pharmacological treatment researches in EDs should include randomized controlled trials with different medications, inpatient versus outpatient trials and the assessment of medication effects for relapse prevention in recovered patients.