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Pharmacotherapy in Anorexia Nervosa

Yakhchi Beykloo, Maedeh; (2021) Pharmacotherapy in Anorexia Nervosa. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

There is currently no evidence base for prescribing antidepressants or antipsychotics in young people with eating disorders. There is a need for greater understanding of psychotropic prescribing in individuals with anorexia nervosa (AN) to provide guidance for their use in clinical practice. The aim of this PhD was to explore and describe the drug utilisation and effectiveness of psychopharmacotherapy in individuals with AN. First, a systematic review was conducted to review the current literature. Next, pharmacotherapy in individuals with AN was explored by three means; 1) through self-reported questionnaires by child and adolescent eating disorder (CAED) psychiatrists on their prescribing practices in AN, 2) using The Health Improvement Network (THIN) database by reporting on AN patterns and describing prescribing patterns in AN in primary care, and 3) in multisite specialised child and young people eating disorder services (CYP EDS) within secondary healthcare settings by describing AN population and examining the effects of psychotropic treatment on weight change. Findings from my review fail to provide strong evidence for any increase in weight associated with the use of psychotropic drugs in adolescents with AN and show some evidence of harmful effects associated with their use. Studies in this thesis have shown there is a high use of psychotropics in AN treatment, with around half of individuals in the primary and secondary care study having a record for psychotropic prescriptions, of which olanzapine and fluoxetine are the most common. No serious adverse events were found in any of the studies. After six months of pharmacotherapy, the mean BMI of those individuals on antipsychotics was greater than the mean BMI of those on antidepressants or no medication, despite having a lower starting BMI upon diagnosis. This thesis found that although a lack of strong existing evidence, psychotropic medications are often prescribed for the treatment of young people with AN.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Pharmacotherapy in Anorexia Nervosa
Event: UCL (University College London)
Language: English
Additional information: Copyright © The Author 2021. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
URI: https://discovery.ucl.ac.uk/id/eprint/10129953
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