Anorexia nervosa:
- cardiac changes
- CBC changes
- neuro changes
- cardiac: orthostatic hypotension, long QTc, arrhythmia
- CBC: anemia, leukopenia, transaminatis, ^BUN, ^ cholesterol
- Neuro: peripheral neuropathy, large ventricles, cognitive impairment
Anorexia nervosa:
-endocrine changes (4)
- low T3 syndrome
- hypoglycemia
- amenorrhea
- loss of libido
- osteoporosis
- hypercoritsolemia
Changes assc with vomiting in AN
- hyponatremic hypokalemic hypochloremic alkalosis
- parotid enlargement
- high amylase
Most common comorbidities assc with AN
- # 1 depression
- obsessive compulsive personality traits
3 AN criteria
- calorie restriction + low weight
- fear/obsession
- disturbed body image
What antidepressants should not be used in AN?
Wellbutrin
(AN+ Wellbutrin lower seizure threshold)
TCAs
(increase risk of cardiac failure)
COD in AN:
- # 1 cardiac failure
- suicide
- starvation
When is hospitalization considered for AN?
-20% or higher
Medications that increase appetite
cyproheptadine
mirtazapine
Prozac
(none definitive for AN treatment)
Length of time requirement for BN
Binging at least once a week for three months
Differences between AN/BN
No low body weight in BN
BN is more ego dystonic= patients more likely to seek help
Russels sign:
callouses on hand from self induced vomiting
Approved medication for BN
60-80 mg/day fluoxetine
How does binge eating disorder differ from AN/BN?
no purging or restricting
Stimulants used to suppress appetite
- phentermine
- amphetamine
Two AEDs assc with decreased appetite
- topiramate
- zonisimide
Orlistat MOA
inhibits pancreatic lipase
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Intro10
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Psych in Children34
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Eating Disorders17
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Psychotic Disorders46
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Forensic Psychiatry24
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Personality Disorders25
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Pharmacology81
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Anxiety, OCD36
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Mood Disorders24
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Neurogcognitive D/O61
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Geri Psych26
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Dissociative/ Somatic31
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Impulse Control6
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Sleep Wake37
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Sexual/ Paraphilic23
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Psychotherapies46
