Bulimia causes of disease and treatment-Part Three

Pathophysiology

The reason is not completely known but it is assumed that there is a reduced synthesis of serotonin in the brain (hiposeroenergichno state), which results in reduced feelings of satiety and increased desire for food intake;
Subjecting diets can lead to a decrease in the level of plasma tryptophan, and further decrease of serotonin. Ingestion of food is also controlled by other nevrotranzmiteri (norepinephrine and neuropeptide ...).


psychopharmacology

Including psihofarma in the process of treating bulimia is optional and the discretion of the attending physician.

In bulimia often observed depressive symptoms as a result of problems associated with eating disorders. There are patients who respond to the inclusion of antidepressants, especially in terms of the frequency of bouts of overeating. It is noteworthy that for the treatment of eating disorders are needed higher doses than in the treatment of patients with depression. But should not be expected therapeutic effect beyond the period of administration.

Preparations of a group of SSRI, MAOI, Trazodone proven effectiveness (81, p.59). Recommended higher doses to be effective (Fluoxetine 60mg QD often recommended in the treatment of bulimia). Must be used carefully because they need a diet free of tyramine.

Ch.Nemeroff reported that sometimes you have to try several different antidepressants before to achieve a result. Bupropion is not recommended for eating disorders because of the risk of seizures.

As a side effect (often transient or mild form) can be observed lift, increased impulsivity, inner restlessness. There is evidence that these substances reduce the likelihood of recurrence. If the patient is not affected by an antidepressant for 2-3 weeks, detection of the level of the plasma can be confirmed that the dose not been administered to the patient, or have been affected by the purging.

In the context of what can be assumed that concomitant medication with atnidepresanti recommended primarily for severe cases of bulimia, which are difficult to psychotherapy.

Along with antidepressants in patients with bulimia have tested numerous other substances acting on brain functions (among them applied initially to treat spasticity karbamatsepin antagonist of opiatitenalokson and also L-tryptophan). All of them, however, did not show a significant positive effect.
Severely malnourished patients are at increased risk of side effects during treatment with psihofarma.
No data for the positive response to antisiolititsi in an attempt to reverse the anxiety svaraana with food intake.

Typical depressive background in the development of eating disorder often docked with antidepressants. Their role is primarily directed to the accompanying mental illness symptoms