Medical Management of Eating Disorder

Dr. Dawn Holemon

Diagnostic Assessment

• Psychiatric

• Medical

• Anorexia nervosa• Bulimia nervosa• ED, nos

• Risk increased with rapid weight change, purging, onset of binges, non compliance with medication

AN, BN or ED, nos

• Refer for inpatient or residential care Pregnancy Diabetes mellitus Abnormal EKG Deficiencies of potassium, magnesium or phosphorus Suicidal ideation

EKG

Associated disorders

• MedicalPANDASPCOS

Associated disorders

• PsychiatricMajor depressionAnxiety disorderBipolar disorderAlcohol and/or drug dependence or abuseBody dysmorphic disorder

Laboratory tests commonly indicated in eating disorder

Liver enzymesBlood countSerum creatinine,

ferritin, vitamin B12

RBC FolateMagnesium,

Phosphorus, Amylase, Potassium, Sodium

TSH

Laboratory tests commonly indicated in eating disorder

UrinalysisUrine drug screenEKGBone density

Medical complications of eating disorder

EdemaWeaknessShortness of breathCardiac arrhythmiasChest painConfusionLoss of consciousness

Medical complications of eating disorder

Refeeding syndrome

-imbalance of electrolytes and fluid -risk factors -symptoms to monitor

Psychotropic medications used to treat eating disorder

SSRISNRITCAMAOI

Other antidepressantTrimonoamine

modulator

Psychotropic medications used to treat eating disorder

Mood stabilizersAntipsychotics, 1st generationAntipsychotics, 2nd generation

Psychotropic medications used to treat eating disorder

Anxiolytics, non benzodiazepineBenzodiazepines, short-actingBenzodiazepines, mid-actingBenzodiazepines, long-acting

Psychotropic medications used to treat eating disorder

InsomniaADHDDependence, opioidDependence, nicotine

Common side effects of medications used to treat eating disorder

LightheadednessSedationDry mouthConstipation

HeadacheAcid refluxnausea

Less common side effects of medication used to treat eating

disorder

ParasthesiaEPSEWeight gain/lossGalactorrhea

Recent research in neuropsychiatry