RESUMO
Anorexia can cause serious somatic complications, linked to undernutrition or associated pathological behaviours. The care pathway drawn up by a multi-discipline team is a real therapeutic challenge. Oral nutritional supplements, enteral nutrition and parenteral nutrition are three possible forms of nutritional assistance.
Assuntos
Anorexia Nervosa/complicações , Anorexia Nervosa/enfermagem , Procedimentos Clínicos , Adolescente , Índice de Massa Corporal , Bulimia/complicações , Bulimia/enfermagem , Nutrição Enteral/enfermagem , Feminino , Humanos , Comunicação Interdisciplinar , Colaboração Intersetorial , Nutrição Parenteral Total/enfermagem , Desnutrição Proteico-Calórica/etiologia , Desnutrição Proteico-Calórica/enfermagem , Fatores de RiscoRESUMO
Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication (psychotropic drugs and medication for somatic and nutritional complications) in the field of anorexia nervosa since the 1960s, (2) to draw practical conclusions for everyday practise and future research. Searches were performed on three online databases, namely MEDLINE, Epistemonikos and Web of Science. Papers published between September 2011 and January 2019 were considered. Evidence-based data were identified from meta-analyses, if there were none, from systematic reviews, and otherwise from trials (randomized or if not open-label studies). Evidence-based results are scarce. No psychotropic medication has proved efficacious in terms of weight gain, and there is only weak data suggesting it can alleviate certain psychiatric symptoms. Concerning nutritional and somatic conditions, while there is no specific, approved medication, it seems essential not to neglect the interest of innovative therapeutic strategies to treat multi-organic comorbidities. In the final section we discuss how to use these medications in the overall approach to the treatment of anorexia nervosa.