Medications for Eating Disorders

Selective Serotonin Reuptake Inhibitors (SSRIs)

• Citalopram]]> (Celexa)
• ]]>Escitalopram]]> (Lexapro)
• ]]>Fluvoxamine]]> (Luvox)
• ]]> Paroxetine]]> (Paxil)
• ]]>Fluoxetine]]> (Prozac)
• ]]> Sertraline]]> (Zoloft)

Selective serotonin reuptake inhibitors (SSRIs) affect the concentration of the neurotransmitter serotonin in the brain, a substance which 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

• Imipramine]]> (Janimine, Tofranil)
• ]]>Desipramine]]> (Norpramin, Pertofrane)

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:

• Dizziness
• Dry mouth
• ]]>Constipation]]>
• Difficulty urinating
• Weight gain
• Low blood pressure
• Sexual dysfunction
• Irregular heart rhythm
• Risk of severe mood and behavior changes (Young adults may be at a higher risk for this side effect.)

Other Antidepressants

• Venlafaxine]]> (Effexor, Effexor XR)
• ]]>Duloxetine]]> (Cymbalta)
• ]]>Mirtazapine]]> (Remeron)
• Nefazodone (Serzone)
• ]]>Bupropion]]> (Wellbutrin)

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
• Sexual dysfunction (not typically experienced with bupropion)
• 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

• Olanzapine]]> (Zyprexa)
• ]]>Risperidone]]> (Risperdal)
• ]]>Ziprasidone]]> (Zeldox)
• ]]>Quetiapine]]> (Seroquel)
• ]]>Aripiprazole]]> (Abilify)

Olanzapine and other similar medicines have shown some benefit in the treatment of anorexia. Further studies are needed, though.

Possible side effects include:

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

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. The use of topiramate remains under study. Further trials are needed.

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 on becoming pregnant.

Possible side effects include:

• Nausea or vomiting
• Dizziness
• 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.

Vitamin and Mineral Supplements

• Calcium]]>
• ]]>Vitamin D]]>

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.