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Drug Prescribing in Child and Adolescent Eating Disorder Services

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Background: 

Psychotropic drugs are not recommended for child and adolescent eating disorders, though they are used empirically for symptomatic treatment and co-morbid conditions. Little is known about rates of prescribing or the beneficial and adverse effects. Objective: 

To ascertain rates and outcomes of psychotropic drug prescribing in child and adolescent eating disorder services. Method: 

Retrospective case note study of eating disorder cases (n =308), seen in one year in seven specialist UK services, covering indications, response to treatment, beneficial and adverse effects. Results: 

Drugs were prescribed for 27%, (mainly anorexia nervosa), 12% before referral to specialist services. The most commonly prescribed drugs were fluoxetine and olanzapine, but 26 different drugs were used. The most common indications were depression, anxiety and ‘pseudo-psychotic’ concerns about weight. Drugs were generally well tolerated, but their effectiveness was uncertain. Conclusions: 

Non-specialists commonly prescribe psychotropic medication to this vulnerable group without reference to specialist services. Specialists prescribe regularly on empirical grounds, without apparent undue consequences, though these may be under-reported. A prospective clinical trial would further clarify risks and benefits.
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Keywords: Adolescence; anorexia nervosa; eating disorders; pharmacology; prescribing

Document Type: Research Article

Affiliations: 1: Section of Child and Adolescent Psychiatry, University of Liverpool, UK., Email: [email protected] 2: The Ellern Mede Centre for Eating Disorders, London, UK 3: Specialist ED Service Child and Adolescent Mental Health Service, Frimley Children’s Centre, Surrey and Borders Partnership NHS Foundation Trust, UK 4: St Georges Child and Adolescent Eating Disorder Service, Springfield Hospital, London, UK 5: Clinical Co-ordinator, Eating Disorders Team, 2gether NHS Trust, Gloucester, UK 6: Head of Feeding and Eating Disorders Service, Department of Child and Adolescent Mental Health, Great Ormond Street Hospital NHS Trust, London, UK 7: The Darwin Centre, 167 Queens Road, Stoke-on-Trent, formerly Huntercombe Hospital, Stafford, UK

Publication date: 01 February 2010

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