The Efficacy of Pharmacological Treatment of Depression in Anorexia Nervosa and Underweight Patients: A Systematic Review.

IF 3.9 2区心理学 Q1 PSYCHIATRY

European Eating Disorders Review Pub Date : 2025-07-11 DOI:10.1002/erv.70008

M J Besjes, S H W Mares, A A van Elburg, J Spijker

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引用次数: 0

Abstract

Objective: Major depressive disorder (MDD) is a frequent comorbidity in anorexia nervosa (AN). This review aimed to evaluate evidence on the effectiveness of pharmacological treatments for MDD in underweight individuals.

Method: A systematic review was conducted using PubMed, Medline, PsycINFO, and Web of Science through March 2025. Nineteen studies with 477 underweight patients were included, involving pharmacological treatment of depressed underweight young adults. Study designs ranged from randomised controlled trials (RCTs) to open-label trials and case reports, with quality assessments performed. Most studies focused on patients with AN; a few included underweight individuals without eating disorders.

Results: No RCTs specifically examined antidepressant treatment for MDD in AN. Most studies prioritised weight restoration and eating disorder symptoms over depressive outcomes. Some case reports indicated potential benefits of medications such as mirtazapine and ketamine. However, evidence was mixed and generally low in quality. Overall, it shows insufficient evidence for the effectiveness of pharmacological treatments in underweight individuals. There is insufficient data to determine whether being underweight affects antidepressant efficacy.

Conclusions: Evidence on pharmacological treatment of MDD in underweight individuals, particularly those with AN, is scarce and inconclusive. Well-designed RCTs are needed to assess the efficacy and safety of antidepressants in this population.

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神经性厌食症和体重过轻患者抑郁的药物治疗效果：系统综述。

目的：重度抑郁障碍（MDD）是神经性厌食症（AN）的常见合并症。本综述旨在评价体重过轻个体的重度抑郁症药物治疗有效性的证据。方法：通过PubMed， Medline， PsycINFO和Web of Science进行系统综述，截止到2025年3月。19项研究纳入了477名体重过轻的患者，包括对体重过轻的抑郁年轻人的药物治疗。研究设计范围从随机对照试验（rct）到开放标签试验和病例报告，并进行了质量评估。大多数研究集中在AN患者身上；少数包括体重过轻但没有饮食失调的人。结果：没有随机对照试验专门检查了AN患者的MDD的抗抑郁治疗。大多数研究优先考虑体重恢复和饮食失调症状，而不是抑郁结果。一些病例报告指出了米氮平和氯胺酮等药物的潜在益处。然而，证据参差不齐，质量普遍较低。总的来说，它没有充分的证据表明药物治疗对体重过轻的个体有效。没有足够的数据来确定体重过轻是否会影响抗抑郁药的疗效。结论：关于体重过轻个体，特别是AN患者的重度抑郁症的药物治疗的证据很少且不确定。需要设计良好的随机对照试验来评估抗抑郁药在这一人群中的有效性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Eating Disorders Review PSYCHOLOGY, CLINICAL-

CiteScore

8.90

自引率

7.50%

发文量

期刊介绍： European Eating Disorders Review publishes authoritative and accessible articles, from all over the world, which review or report original research that has implications for the treatment and care of people with eating disorders, and articles which report innovations and experience in the clinical management of eating disorders. The journal focuses on implications for best practice in diagnosis and treatment. The journal also provides a forum for discussion of the causes and prevention of eating disorders, and related health policy. The aims of the journal are to offer a channel of communication between researchers, practitioners, administrators and policymakers who need to report and understand developments in the field of eating disorders.