目标:有注意力问题的人饮食失调的风险增加。本文旨在系统回顾和综合现有证据,以治疗伴有或不伴有注意缺陷多动障碍(ADHD)的神经性贪食症(BN)或神经性厌食症(AN)患者。
方法:根据系统评价和荟萃分析(PRISMA)指南的首选报告项目进行系统评价。审查方案已在开放科学框架(OSF)注册表中注册,并使用JoannaBriggs研究所(JBI)关键评估工具对文献进行了关键评估。
结果:13篇文章符合纳入标准,包括两项准实验研究,一项随机对照试验,四个案例系列,和六个病例报告。26例病例来自研究,32例来自病例系列/报告。单例报告中只有两例诊断为AN,其余的有BN。兴奋剂包括甲基苯丙胺,lisdexamfetamine,哌醋甲酯,硫酸右苯丙胺和混合苯丙胺盐。在几乎所有BN病例中,据报道饮食失调症状均有所减轻。不良反应的发生率很高,包括体重减轻,食欲下降,心动过速,口干,疲劳,失眠,躁动,恶心,磨牙症,头痛,心悸,血压变化,烦躁,焦虑,情绪低落,和出汗。
结论:目前没有足够的证据支持使用兴奋剂药物治疗BN或AN的症状。作者建议考虑筛查BN患者的ADHD。
OBJECTIVE: People with attentional problems are at increased risk of eating disorders. This paper aimed to systematically review and synthesize the existing evidence on stimulant medication in the management of patients with bulimia nervosa (BN) or anorexia nervosa (AN) with or without comorbid attention deficit hyperactivity disorder (ADHD).
METHODS: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A protocol for the review was registered with Open Science Framework (OSF) Registry and critical appraisal of the literature was conducted using Joanna Briggs Institute (JBI) Critical Appraisal Tools.
RESULTS: Thirteen articles met inclusion criteria including two quasi-experimental studies, one randomized controlled trial, four case series, and six case reports. 26 cases were included from studies and 32 from case series/reports. Only two cases from a single case report had a diagnosis of AN, while the remainder had BN.
Stimulants included methylamphetamine, lisdexamfetamine, methylphenidate, dextroamphetamine sulphate and mixed amphetamine salt. In nearly all cases of BN there were reported reductions in eating disorder symptoms. The rates of adverse effects were high and included weight loss, decreased appetite, tachycardia, dry mouth, fatigue, insomnia, restlessness, nausea, bruxism, headache, palpitations, blood pressure changes, irritability, anxiety, depressed mood, and diaphoresis.
CONCLUSIONS: There is currently insufficient evidence to support the use of stimulant medications to treat symptoms of BN or AN. The authors recommend considering screening patients with BN for ADHD.