Pharmacological interventions for anorexia nervosa
There is a very limited evidence base for the pharmacological treatment of anorexia nervosa. A
range of drugs may be used in the treatment of comorbid conditions but caution should be
exercised in their use given the physical vulnerability of many people with anorexia nervosa.
Medication should not be used as the sole or primary treatment for anorexia
nervosa.
Caution should be exercised in the use of medication for comorbid conditions
such as depressive or obsessive– compulsive features as they may resolve
with weight gain alone.
When medication is used to treat people with anorexia nervosa, the side
effects of drug treatment (in particular, cardiac side effects) should be carefully
considered and discussed with the patient because of the compromised
cardiovascular function of many people with anorexia nervosa.
Healthcare professionals should be aware of the risk of drugs that prolong the
QTc interval on the ECG; for example, antipsychotics, tricyclic antidepressants,
macrolide antibiotics, and some antihistamines. In patients with anorexia
nervosa at risk of cardiac complications, the prescription of drugs with side
effects that may compromise cardiac functioning should be avoided.
If the prescription of medication that may compromise cardiac functioning is
essential, ECG monitoring should be undertaken.
All patients with a diagnosis of anorexia nervosa should have an alert placed in
their prescribing record concerning the risk of side effects.