PDF(Pubmed)
Abstract：
BACKGROUND: There are no U.S. Food and Drug Administration (FDA)-approved medications for the treatment of anorexia nervosa (AN). Various medication classes have been evaluated for benefits in this population, including antipsychotics. Studies focused on use of antipsychotics for assistance with weight restoration in AN produced conflicting results. While current evidence does not suggest that antipsychotic medications can be generally recommended for persons with AN, some individuals might benefit from an antipsychotic medication for anxiety, mood, and the cognitive distortions that accompany the illness. It is well-established that atypical antipsychotics can cause weight gain when taken by other psychiatric populations. This published data can understandably limit the willingness of persons with AN to trial these medications. Given the conflicting results of studies examining antipsychotic-related weight gain in AN, it is currently hypothesized that individuals with extreme anorexia nervosa, restricting type, do not experience the weight gain seen in other psychiatric populations utilizing atypical antipsychotics.
METHODS: Two hundred seventy-six individuals with extreme AN were enrolled in this retrospective, case-control study between April 1, 2016 and June 30, 2022 utilizing study-specific inclusion and exclusion criteria. Clinical and demographic data, including use of atypical antipsychotics and weights, were retrospectively obtained from chart review. Variables were assessed for normality using univariate statistics. Continuous variables were described using means (M) and standard deviations (SD) or medians and interquartile ranges (IQR) based on normality. Differences in weight gain between cohorts was ascertained via independent samples t-test. P values of < 0.05 were considered statistically significant, and all analyses were completed using SAS Enterprise Guide software version 7.1 (SAS Institute, Cary, NC) and R version 4.3.1 (R Core Team, 2023).
RESULTS: Use of antipsychotics in this population of individuals with extreme AN did not impact the rate of weight gain (M: 1.7 kg/week, SD: 0.9 and 0.8, for cases and controls respectively).
CONCLUSIONS: Weight gain is often cited by individuals with AN as a feared side effect of antipsychotic medications. In this study, there was no difference in weight trends for individuals taking atypical antipsychotic medications during the refeeding process compared with individuals who were not.
While antipsychotics are not FDA-approved for, and cannot be generally recommended for, people diagnosed with anorexia nervosa, there are those who may derive benefit from utilizing these medications for their rigid and circular thoughts associated with the disorder, or for their mood and anxiety symptoms. Yet, many such individuals are hesitant to take these medications due to their fear of the weight gain which has been associated with their usage. In this study population of individuals suffering from extreme AN, who were undergoing refeeding and weight restoration, there was no impact on weight gain trends in individuals taking atypical antipsychotics compared to individuals who were not taking these medications.
METHODS: Two hundred seventy-six individuals with extreme AN were enrolled in this retrospective, case-control study between April 1, 2016 and June 30, 2022 utilizing study-specific inclusion and exclusion criteria. Clinical and demographic data, including use of atypical antipsychotics and weights, were retrospectively obtained from chart review. Variables were assessed for normality using univariate statistics. Continuous variables were described using means (M) and standard deviations (SD) or medians and interquartile ranges (IQR) based on normality. Differences in weight gain between cohorts was ascertained via independent samples t-test. P values of < 0.05 were considered statistically significant, and all analyses were completed using SAS Enterprise Guide software version 7.1 (SAS Institute, Cary, NC) and R version 4.3.1 (R Core Team, 2023).
RESULTS: Use of antipsychotics in this population of individuals with extreme AN did not impact the rate of weight gain (M: 1.7 kg/week, SD: 0.9 and 0.8, for cases and controls respectively).
CONCLUSIONS: Weight gain is often cited by individuals with AN as a feared side effect of antipsychotic medications. In this study, there was no difference in weight trends for individuals taking atypical antipsychotic medications during the refeeding process compared with individuals who were not.
While antipsychotics are not FDA-approved for, and cannot be generally recommended for, people diagnosed with anorexia nervosa, there are those who may derive benefit from utilizing these medications for their rigid and circular thoughts associated with the disorder, or for their mood and anxiety symptoms. Yet, many such individuals are hesitant to take these medications due to their fear of the weight gain which has been associated with their usage. In this study population of individuals suffering from extreme AN, who were undergoing refeeding and weight restoration, there was no impact on weight gain trends in individuals taking atypical antipsychotics compared to individuals who were not taking these medications.
摘要：
背景：目前还没有美国食品和药物管理局（FDA）批准的治疗神经性厌食症（AN）的药物。已经评估了各种药物类别在该人群中的益处，包括抗精神病药.研究集中在使用抗精神病药协助AN恢复体重方面产生了矛盾的结果。虽然目前的证据并不表明抗精神病药物通常可以推荐用于AN患者，有些人可能会从抗精神病药物治疗焦虑症中受益，心情,以及伴随疾病的认知扭曲。公认的是，当其他精神病人群服用非典型抗精神病药时，会导致体重增加。这些公布的数据可以理解地限制患有AN的人试验这些药物的意愿。鉴于在AN中检查抗精神病药相关体重增加的研究结果相互矛盾，目前假设患有极度神经性厌食症的人，限制类型,在使用非典型抗精神病药物的其他精神病人群中，不要经历体重增加。
方法：本回顾性研究纳入了两百七十六名患有极端AN的个体，2016年4月1日至2022年6月30日的病例对照研究,采用研究特异性纳入和排除标准.临床和人口统计数据，包括使用非典型抗精神病药和砝码，是从图表回顾中回顾性获得的。使用单变量统计来评估变量的正态。使用均值（M）和标准偏差（SD）或基于正态的中位数和四分位距（IQR）描述连续变量。通过独立样本t检验确定队列之间体重增加的差异。P值<0.05被认为具有统计学意义，所有分析均使用SAS企业指南软件7.1版(SASInstitute，凯里,NC）和R版本4.3.1（R核心团队，2023年）。
结果：在患有极端AN的人群中使用抗精神病药不会影响体重增加的速度（M：1.7kg/周，SD：0.9和0.8，分别用于病例和对照）。
结论：体重增加常被认为是抗精神病药物的副作用。在这项研究中,与未服用非典型抗精神病药物的个体相比,在再喂养过程中服用非典型抗精神病药物的个体的体重趋势没有差异.
虽然抗精神病药不是FDA批准的，通常不能推荐，被诊断为神经性厌食症的人，有些人可能会从使用这些药物中受益，因为他们的僵化和循环思想与疾病相关，或者他们的情绪和焦虑症状。然而，许多这样的人是犹豫服用这些药物，因为他们担心体重增加，这已经与他们的使用有关。在这项研究中，患有极端AN的人群，他们正在接受重新喂食和体重恢复，与未服用这些药物的个体相比,服用非典型抗精神病药物的个体对体重增加趋势没有影响.
方法：本回顾性研究纳入了两百七十六名患有极端AN的个体，2016年4月1日至2022年6月30日的病例对照研究,采用研究特异性纳入和排除标准.临床和人口统计数据，包括使用非典型抗精神病药和砝码，是从图表回顾中回顾性获得的。使用单变量统计来评估变量的正态。使用均值（M）和标准偏差（SD）或基于正态的中位数和四分位距（IQR）描述连续变量。通过独立样本t检验确定队列之间体重增加的差异。P值<0.05被认为具有统计学意义，所有分析均使用SAS企业指南软件7.1版(SASInstitute，凯里,NC）和R版本4.3.1（R核心团队，2023年）。
结果：在患有极端AN的人群中使用抗精神病药不会影响体重增加的速度（M：1.7kg/周，SD：0.9和0.8，分别用于病例和对照）。
结论：体重增加常被认为是抗精神病药物的副作用。在这项研究中,与未服用非典型抗精神病药物的个体相比,在再喂养过程中服用非典型抗精神病药物的个体的体重趋势没有差异.
虽然抗精神病药不是FDA批准的，通常不能推荐，被诊断为神经性厌食症的人，有些人可能会从使用这些药物中受益，因为他们的僵化和循环思想与疾病相关，或者他们的情绪和焦虑症状。然而，许多这样的人是犹豫服用这些药物，因为他们担心体重增加，这已经与他们的使用有关。在这项研究中，患有极端AN的人群，他们正在接受重新喂食和体重恢复，与未服用这些药物的个体相比,服用非典型抗精神病药物的个体对体重增加趋势没有影响.
