Treating Eating Disorders with Psych Meds

Treatment for an eating disorder commonly includes a multi-disciplinary approach with the psychotherapist and psychiatrist as the primary treatment providers. In addition, a licensed dietician and a primary care physician make up the rest of the team involved in the care of the patient.   Depending on the type of eating disorder diagnosed, use of specific pharmacotherapy can also be effective.

To date, there has not been much success in treating anorexia nervosa with psychotropic drugs to cure the physical aspects of the disease. Indeed, food is still the best medicine for regaining physical wellbeing for anorectics. However, some SSRIs have shown promise in treating the underlying mental health conditions that accompany the eating disorder, once a healthy weight has been attained.

There has been much more success treating patients with psych meds who present with bulimia nervosa or a binge eating disorder. It has been found that bulimics respond well to antidepressants, even if they are not suffering from depression.

 Drug Treatment for Anorexia Nervosa

The most challenging eating disorder to treat is anorexia. Psychotherapy remains the primary tool used to stabilize and treat this eating disorder, as there are typically serious mental health issues that accompany the disordered eating. To date, there has been little evidence that medication is effective in treating anorexia, but when mood disorders such as depression or obsessive-compulsive disorder accompany the disorder, Fluoxetine (Prozac) has helped the anorectic patient manage these.

Side effects of these selective serotonin uptake inhibitors (SSRIs) are generally mild and tolerated well for most patients. Side effects can include:

  • Drowsiness
  • Decreased interest in sex
  • Nausea
  • Diarrhea
  • Weight gain
  • Agitation

If the patient does not tolerate the SSRI, then their psychiatrist may prescribe olanzapine (Zyprexa), a psychotropic drug used primarily to treat schizophrenia. In a patient who has anorexia nervosa, olanzapine can help them gain weight and modify their obsessive thinking. Side effects of olanzapine include:

  • Dizziness
  • Weakness
  • Drowsiness
  • Lightheadedness
  • Dyskinesia (movement disorder)

In addition, anti-anxiety medications can be effective in reducing the anxiety the patient may experience before eating.

Drug Treatment for Bulimia Nervosa

 Patients diagnosed with bulimia nervosa tend to respond well to fluoxetine in reducing the binge eating and purging. This is the only antidepressant that is approved by the U.S. Food and Drug Administration to treat bulimia nervosa.

In addition to fluoxetine, another group of antidepressant drugs called tricyclics (Norpramin, Tofranil, and Elavil) have been prescribed with some success. They have similar side effects as the antidepressants, but also have more risk of overdose and drug interactions.

Several placebo-controlled trials have shown topiramate (Topamax) to be effective in controlling binge and purge behaviors. Side effects include taste perversion, difficulty concentrating, and a sensation of pins and needles or skin crawling.

Studies with lithium demonstrated it is ineffective in treating bulimia.

Drug Treatment for Binge Eating Disorder

In treating binge eating disorders, the most effective drug has been topiramate , a medication usually associated with treating epileptic seizures and migraine headaches, as well as bipolar disorder. Side effects are listed above.

SSRIs (Prozac and Zoloft) and appetite suppressants (such as Meridia) have also been effective in treating the binge-eating behaviors. Appetite suppressants can help suppress hunger, which helps in weight loss, but they can have serious side effects. Common side effects of Meridia include dangerous changes in blood pressure, headache, dry mouth, and sleep disturbance.

Get Help Now

Casa Serena offers a safe and supportive environment to treat Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorders. Casa Serena incorporates yoga and mindfulness, expressive arts therapy, family education, body image support group, and many more effective program components. Our caring, professional staff can help you reclaim your power and gently guide your or your loved one to a full, healthy recovery. Call (925) 682-8252


Eating Disorders Treated with EMDR

The Treatment Benefits of Eye Movement Desensitization and Reprocessing

Behind each person’s eating disorder is a unique set of causes. There is no one single reason why an otherwise healthy individual might develop disordered eating habits. Causes range from taking extreme measures to fit in to a perceived societal ideal of physical beauty to trauma to obsessive-compulsive disorder. Often an eating disorder involves a co-occurring condition, such as a substance use disorder or mental health disorder, such as anxiety or depression. No matter the root cause of the eating disorder, treating the individual in order to attain not only a healthy weight, but also a healthy mind is the ultimate goal.

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a therapeutic treatment technique to manage a variety of disorders, including eating disorders. It was developed in 1987 by psychologist, Francine Shapiro, when she noticed a link between eye movement and cognition, and the resulting effect it had on negative emotions.

EMDR involves a trained therapist initially working with the patient to identify memories or thoughts that are causing emotional pain and distress that may be contributing to a dangerous eating disorder. Once the source of the pain or trauma is determined, the therapist uses horizontal hand movements, sometimes in conjunction with tones played through the patient’s headphones, to provoke a series of eye movements while the patient thinks about the distressing core issue.

The goal of EMDR is to trigger the brain to replicate the process that happens during sleep, where the brain processes the day’s events through images and rapid eye movement (REM phase). The thesis of EMDR is that certain circumstances or events that were causing stress or discord often become softened over night, as the brain’s natural processes help resolve the issue. Often the next morning the troubling event or issue has lost much of its potency.

How Does EMDR Help Eating Disorders?

During the course of the EMDR therapeutic session, memories and emotions can rise to the surface. As the sessions progress, connections can be made between the emotions experienced as a result of reliving the traumatic or distressing memories, and the subsequent anxiety that is contributing to disordered eating.

Revelations that result from EMDR, such things as a controlling parent, parents getting divorced, physical or emotional abuse, or loss and grief, can aid mental health professionals in treating eating disorders by getting to the root cause. That cause becomes the target for the patient’s focus during the sessions, allowing for a change in their behavioral response to it.

Eventually, the intense reaction the patient once had to the trigger becomes less pronounced, and the patient is less motivated to engage in their disordered eating patterns. The process of EMDR, having brought about the revelation of what the underlying issue is, begins to resolve the painful memories, diminishing the patient’s need to continue anorexic or bulimic behaviors.

Help for Eating Disorders

There is help available for those suffering from a debilitating eating disorder. At Casa Serena, our supportive and compassionate professionals can help you in your process of developing life-long skills for healing. It takes courage to ask for help, and we honor that courage and believe in your ability to make positive changes in your life needed to let go of an eating disorder.  Call our Admissions Team today to learn more at (925) 682-8252.

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