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Chapter 47. Psychopharmacological Treatment

James E. Mitchell, M.D.; Scott J. Crow, M.D.
DOI: 10.1176/appi.books.9781585622986.261987

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In parallel with the development of various pharmacological strategies for the treatment of other psychiatric disorders over the last few decades, considerable research has focused on the development of drug treatments as both primary and ancillary interventions in the treatment of clinical eating disorders. As we will see, the literature on anorexia nervosa is, at this point, still quite limited for several reasons. First, anorexia nervosa is a relatively rare condition. Second, individuals with anorexia nervosa usually are quite ill and require multiple interventions, often including in-hospital treatment, medical management, and psychotherapy. Therefore, the complexity of treatment designs makes it very difficult to design pharmacological trials for this population. Third, patients with anorexia nervosa are not particularly insightful about their illness and are frequently hesitant to participate in randomized treatment trials. Therefore, as will be seen, the results of studies thus far in anorexia nervosa are for the most part inconclusive, although some interesting findings have surfaced in the available studies that are important to clinical practice.

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