Particularly MD, an eating disorder specialist at Langone

Particularly in anorexia nervosa, medical treatments do not have a
clear role in the treatment of this condition. A study conducted from January
2000 to May 2005, uses a methodology of using randomized, placebo-controlled,
double blind trial, using 93 patients with anorexia nervosa. At the New York
State Psychiatric Institute or Toronto General Hospital, the patients received a
day-program or intensive inpatient treatment. The objective of this research
was to ascertain whether fluoxetine encouraged recovery and continued
time-to-relapse among weight restored patients with anorexia nervosa. Thus
eligible members for this randomised stage of the trial had to regain weight to
a minimum body mass index of 19.0. Fluoxetine or a placebo was randomly
assigned to patients, in which 49 participants were allocated fluoxetine and 44
to placebo1,
as well as cognitive behavioural therapy. A correlative percentage of patients maintained a body mass
index of 18.5, and stayed in the study for 52 weeks (fluoxetine, 26.5%; placebo,
31.5%; P = .57)2.
In a Cox proportional hazards analysis, with pre-randomisation body mass index,
site, and diagnostic subtype as covariates, there was no significant difference
between fluoxetine and placebo in time-to-relapse (hazard ratio, 1.12; 95% CI,
0.65-2.01; P = .64).3

As part of the complete treatment program, fluoxetine is
prescribed to the anorexic, in combination with therapy as a holistic
treatment, in order to manage conditions including anxiety, social phobia and
depression. Depression is often a contributing factor in anorexia nervosa,
where the anorexic strives for perfection, which cannot be achieved. According to Ira M. Sacker, MD, an eating
disorder specialist at Langone Medical Centre at New York University and author of Regaining Your Self:
Understanding and Conquering the Eating Disorder Identity, “People who
develop eating disorders feel as people that they’re not good enough”. 4
Depression is often the underlying factor behind this perspective.  As a result, Fluoxetine, a selective serotonin
reuptake inhibitor (SSRIs), is prescribed to manage this mental illness. Experts
believe depression is caused by an imbalance of neurotransmitters, thus fluoxetine
works by prohibiting the reuptake of serotonin, a neurotransmitter which alters
the mood and social behaviour, sleep, sexual desire and function, memory and
appetite and digestion, by nerve cells after discharge. Changes to the
serotonin function have been associated with disorders, including depression
and eating disorders.

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To conclude the case study that spanned the duration from
2000 – 2005, it suggested that fluoxetine was not beneficial, compared with a
placebo in the treatment of anorexics following weight restoration. The rate of
relapse was significantly high for the sectors that ingested the placebo or
fluoxetine, and the time to relapse had no considerable difference between the
two treatment groups. The evidence to suggest that fluoxetine was not an
effective drug was also reinforced by a study that took place in April 1998,
where 31 women received a target
daily dose of 60 mg of fluoxetine over a 7-week study5.
Yet again, fluoxetine did not appear to have had a beneficial effect on the
inpatients of anorexia nervosa.

SRI’s are used largely as antidepressants, for example,
SSRI’s, Serotonin–norepinephrine reuptake inhibitor (SNRI’s) and Tricyclic
antidepressant (TCA’s) or Olanzapine (Zyprexa, Zydis) or other antipsychotics;
however they can also be used to treat conditions, such as anorexia. However
from this evidence, it suggests that fluoxetine is not a particularly effective
treatment of anorexia nervosa, with the quick relapse time after medication,
and it did not appear to have any significant effect over the use of a placebo.
Further studies need to be undertaken on developing advanced models to be able
to discern the persistence of this mental condition and to discover new
pharmacological and psychological treatment approaches.

1Walsh, B., Kaplan, A., Attia,
E., Olmsted, M., Parides, M., Carter, J., Pike, K., Devlin, M., Woodside, B.,
Roberto, C. and Rockert, W. (2018). Fluoxetine After Weight Restoration in
Anorexia Nervosa, online Available at: http://jamanetwork.com/journals/jama/fullarticle/202996, Accessed 24 Jan. 2018

2
Walsh, B., Kaplan, A.,
Attia, E., Olmsted, M., Parides, M., Carter, J., Pike, K., Devlin, M.,
Woodside, B., Roberto, C. and Rockert, W. (2018). Fluoxetine After Weight
Restoration in Anorexia Nervosa, online Available at: http://jamanetwork.com/journals/jama/fullarticle/202996, Accessed 24 Jan. 2018

3
Walsh, B., Kaplan, A.,
Attia, E., Olmsted, M., Parides, M., Carter, J., Pike, K., Devlin, M.,
Woodside, B., Roberto, C. and Rockert, W. (2018). Fluoxetine After Weight
Restoration in Anorexia Nervosa, online Available at: http://jamanetwork.com/journals/jama/fullarticle/202996, Accessed 24 Jan. 20

 

4
https://www.webmd.com/mental-health/eating-disorders/features/eating-disorders#1

5 Volume
155, Issue 4, April 1998, pp. 548-551- https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.155.4.548

 

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