Anorexia and bulimia nervosa: Neurobiology and pharmacotherapy

This review provides an overview of some neurobiological factors that may c ontribute to the development and maintenance of eating disorders, and the p sychopharmacological treatment of anorexia and bulimia nervosa; Various met abolic, physiologic, and neuroendocrine disturbances are associated with bu limia and anorexia nervosa, but it is often not clear whether they represen t state or trait markers of the disorders. While most patients with bulimia nervosa who receive appropriate pharmacotherapy will experience significan t short-term improvement, there is a substantial rate of relapse during lon g-term continuation treatment with medication. Strategies that appear to im prove long-term outcome in bulimia nervosa include combination treatment wi th cognitive-behavioral therapy (CBT) and changing to an alternative antide pressant medication. The role for medication treatment in anorexia nervosa remains very limited, although the SSRI antidepressant fluoxetine may have a limited role in longterm treatment of anorexia.