biological treatment for AN: drug therapy

• the 2 biological drug treatments for AN are: SSRI (selective serotonin reuptake inhibitor) and antipsychotic
• how do SSRIs work

  • SSRI is an antidepressant
  • functions by blocking serotonin reuptakes and preventing serotonin in the synapse from being reabsorbed into presynaptic neuron - increasing overall availability of serotonin in the synapse
  • serotonin binding is beneficial in maintenance of appetite which help individuals have a less restrictive diet
• SSRI can alleviate symptoms of AN:

  • helps put on weight
  • less obsessive thoughts about food
  • reduces overall anxiety levels as SSRIs affect the entire brains serotonin which leads to overall increase of mood lessening anxiety
• SSRI can reduce the likelihood of relapse
• what is a common SSRI

  a common SSRI is fluoxetine - used to treat anxiety and depressive comorbid symptoms of patients with AN
• what are antipsychotics

  • antipsychotic drugs act as dopamine antagonists
  • occupy dopamine D2 receptors in neurons dendrites but don't activate them.
  • they can lessen the effects of dopamine leading to lower anxiety levels in food as they regulate overactive dopamine system in people with AN
• what is olanzapine

  • a common atypical antipsychotic drug is olanzapine - targets both dopamine and serotonin receptors
  • blocks D2 receptors stopping the absorption of dopamine and blocking 5-HTA receptors for serotonin in neural pathways within the brain
  • helps to alter motivation and reward perception
  • drug can help reduce obsessive thoughts about food which decrease patients anxiety at meal times so encouraging regular eating and helping recovery
• what is olanzapine linked to

  • increasing production of ghrelin (hunger hormone)
  • taking this drug will induce appetite resulting in weight gain as a side effect - useful as AN patients have significantly low body weight for age and sex
• strength of biological treatment

  • research evidence of drugs improving AN symptoms
  • boachie (2003) used olanzapine to treat 4 children with AN -gained a kg of weight a week and experienced less anxiety at meal times
  • antipsychotics can treat AN symptoms of extremely low body weight
• weakness (counter)

  • small sample size
  • research not applicable to people of older age
  • therefore, results not as reliable as we dont know the effects of olanzapine on adults
• strength

  • drug improved AN symptoms
  • jensen and mejlhede (2000) - case studies of 3 patients who took olanzapine - patients showed an increase in positive body image more realistic of what they actually looked like
  • antipsychotic can treat AN symptom of a distorted perception of ones body shape or size
• weakness

  • difficulties in convincing patients to take drug and continue within first 2 months
  • it takes a few weeks before a full antipsychotic effect is achieved
  • therefore, as these drugs take time to have effects and have side effects such as: dizziness and constipation, it may be challenging for patients to use olanzapine
• weakness

  • effectiveness of drugs in treating AN is being challenged
  • lebrow (2013) found people with AN who take antipsychotics have increases in BMI and body satisfaction but were not significantly different than those in placebo groups - some instances were associated with higher anxiety levels
  • drug therapies might not be an effective treatment for AN
• what are the NICE guidelines

  NICE (national institute for health and care excellence) - do not recommend using drug therapy as a first choice for AN, as they affect weight gain and depression in patients

  • role is to improve outcomes for people using the NHS and other public healthcare services