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Medications for Eating Disorders

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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Medications do not cure eating disorders, although they may help certain aspects of eating disorders, including the physical and psychiatric conditions associated with them. Not all people with eating disorders respond to these medicines.

Over-the-Counter Medications

Vitamin and mineral supplements are used to treat bone issues related to an eating disorder. These medications include:

  • Calcium
  • Vitamin D

Prescription Medications

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) affect the concentration of the neurotransmitter serotonin in the brain. This substance plays a role in anxiety , depression , and possibly eating disorders.

SSRIs can be helpful for bulimia , especially in patients who have not responded to psychosocial treatment. The medicines have not been shown to be as effective in treating anorexia . Although, there does appear to be a benefit in patients with both anorexia and obsessive-compulsive disorder (OCD). SSRIs have also been shown to be helpful for weight maintenance and for resolving mood and anxiety symptoms associated with both anorexia and bulimia. Improvement is usually seen 4-6 weeks after beginning treatment.

Possible side effects include:

  • Nausea
  • Diarrhea
  • Insomnia or sedation
  • Sexual dysfunction
  • Anxiety
  • Appetite increase or decrease
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients; young adults may be at a higher risk for this side effect
Tricyclic Antidepressants

Tricyclic antidepressants are thought to regulate serotonin, norepinephrine, and other brain chemicals. They may be helpful for bulimia and may be used to treat co-occurring mood or anxiety disorders. These drugs are highly toxic if taken in large doses. Therefore, they are often not prescribed for suicidal patients. Side effects are also more likely in patients who are malnourished.

Possible side effects include:

  • Lightheadedness
  • Dry mouth
  • Constipation
  • Difficulty urinating
  • Weight gain
  • Low blood pressure
  • Heart rhythm problems
  • Sexual dysfunction
  • Irregular heart rhythm
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients; young adults may be at a higher risk for this side effect
Other Antidepressants
  • Bupropion (Wellbutrin)—this medicine may cause seizures in people who binge and purge, so it is not used in those with bulimia.

There are several other antidepressants that work in a variety of different ways, affecting the concentrations of serotonin, norepinephrine, and dopamine. These medicines are usually used after an SSRI has been tried and shown to be ineffective (or caused unwanted side effects). Atypical antidepressants are often helpful for bulimia. They may be used to treat co-occurring mood or anxiety disorders. Improvement is usually seen 4-6 weeks after beginning treatment.

Possible side effects include:

  • Nausea
  • Nervousness
  • Appetite increase or decrease
  • Risk of severe mood and behavior changes; young adults may be at a higher risk for this side effect
Atypical Antipsychotic Medications

Atypical antipsychotic medications have shown some benefit in the treatment of anorexia.

Possible side effects include:

  • Lightheadedness, sleepiness, blurred vision, or a change in the ability to think clearly
  • Nervousness
  • Hostility
  • Dry mouth
  • Weight gain
  • High blood sugar
  • Low blood pressure
  • High cholesterol and triglyceride levels
  • Insomnia
  • Constipation
  • Sexual dysfunction
  • Headache
Other Medications
  • Topiramate (Topamax)

There is some evidence that this drug, usually used to control seizures, can also have an effect on the frequency of binging and purging behavior in bulimia.

Possible side effects include:

  • Drowsiness
  • Nervousness
  • Confusion
  • Problems in cognitive ability
Medications That Affect Appetite
  • Cyproheptadine (Periactin)
  • Megestrol (Megace)

If you have anorexia, cyproheptadine is an antihistamine that may be prescribed to help stimulate your appetite. If you have bulimia, this drug is not helpful.

Possible side effects include:

  • Drowsiness
  • Upset stomach or stomach pain
  • Dryness of mouth, nose, or throat
  • Increased appetite
  • Weight gain
  • Thickening of mucus

Megestrol is a man-made chemical. It is similar to the female hormone progesterone. It may be prescribed to help stimulate your appetite. It is not typically used in bulimia. Megestrol should be avoided in women who are pregnant or plan to become pregnant.

Possible side effects include:

  • Nausea or vomiting
  • Lightheadedness
  • Mild shortness of breath
  • Weakness
  • Headache
  • Menstrual bleeding
  • Hot flashes or sweating
  • Decreased sex drive
  • Insomnia

If you have diabetes or a history of blood clots, be sure to tell your doctor. You may be prescribed a different medicine.

Over-the-Counter Medications

Vitamin and Mineral Supplements

If you have anorexia, your doctor may ask you to take a calcium supplement and a multivitamin containing vitamin D . These supplements help prevent bone loss that results from inadequate nutrient intake and low hormone levels, which are seen in people who have anorexia.

Special Considerations

If you are taking medicines, follow these general guidelines:

  • Take your medicine as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Ask what the results and side effects may be. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medicines and herb or dietary supplements.
  • Plan ahead for refills so you do not run out.

Revision Information

  • About eating disorders. National Association of Anorexia Nervosa and Associated Disorders website. Available at: http://www.anad.org/get-information/about-eating-disorders . Accessed July 11, 2013.

  • Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273 . Updated August 12, 2010. Accessed July 11, 2013.

  • Eating disorders. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml . Updated 2011. Accessed July 11, 2013.

  • Gowers SG. Management of eating disorders in children and adolescents. Arch Dis Child. 2008;93(4):331-334. Epub 2007 Oct 9.

  • Hall MN, Friedman RJ, et al. Treatment of bulimia nervosa. Am Fam Physician. 2008;77(11):1588,1592. Available at: http://www.aafp.org/afp/2008/0601/p1588.html

  • Hunt TJ, Thienhaus O, et al. The mirror lies: body dysmorphic disorder. Am Fam Physician. 2008;78(2):217-222. Available at: http://www.aafp.org/afp/2008/0715/p217.html

  • Yager J, Devlin MJ, et al. Practice Guideline for the Treatment of Patients with Eating Disorders. 3rd ed. American Psychiatric Association; 2006. Available at: http://www.guideline.gov/content.aspx?id=9318 . Accessed July 11, 2013.