Dronabinol in severe, enduring anorexia nervosa: A randomized controlled trial

Authors

  • Alin Andries MD,

    Corresponding author
    1. Center for Eating Disorders, Department of Endocrinology, Odense University Hospital, Odense C, Denmark
    • Correspondence to: Alin Andries, Center for Eating Disorders, Department of Endocrinology, Odense University Hospital, DK-5000 Odense C, Denmark. E-mail: alin@dadlnet.dk

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  • Jan Frystyk,

    1. Department of Endocrinology and Internal Medicine, Aarhus University Hospital and Medical Research Laboratories, Aarhus C, Denmark
    2. Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus C, Denmark
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  • Allan Flyvbjerg,

    1. Department of Endocrinology and Internal Medicine, Aarhus University Hospital and Medical Research Laboratories, Aarhus C, Denmark
    2. Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus C, Denmark
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  • René Klinkby Støving

    1. Center for Eating Disorders, Department of Endocrinology, Odense University Hospital, Odense C, Denmark
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  • Conflicts of Interest: This research was carried out independently by the Center for Eating Disorders, Department of Endocrinology, Odense University Hospital. Competing interests: JF and AF have received financial support from the Department of Clinical Medicine, Aarhus University for the submitted work. The authors have had no financial relationships in the previous three years with any organizations that might have an interest in the submitted work, and no other relationships or activities that could appear to have influenced the submitted work.

  • Supported from Department of Clinical Medicine, Aarhus University.

ABSTRACT

Objective

The evidence for pharmacological treatment of severe, longstanding anorexia nervosa (AN) is sparse and the few controlled pharmacologic studies have focused on a narrow range of drugs. The aim of the present study was to investigate the effects of treatment with a synthetic cannabinoid agonist on body weight and eating disorder-related psychopathological personality traits in women with severe, enduring AN.

Method

This add-on, prospective, randomized, double blind, controlled crossover study was conducted between 2008 and 2011 at a specialized care center for eating disorders. Twenty-five women over 18 years with AN of at least 5 years duration were randomized to treatment with either dronabinol-placebo or placebo-dronabinol. In addition to the standardized baseline therapeutic regime, the participants received dronabinol, 2.5 mg twice daily for 4 weeks and matching placebo for 4 weeks, separated by a 4-week wash-out period. Primary outcome was the mean change in body weight. Secondary outcome was score changes on the Eating Disorder Inventory-2 (EDI-2). Data were analyzed for the 24 patients who completed the trial.

Results

During dronabinol treatment, participants gained 0.73 kg (t = 2.86, df = 22, p < 0.01) above placebo without significant psychotropic adverse events. Dronabinol significantly predicted weight gain in a multiple linear regression including EDI-2 body dissatisfaction score and leptin. EDI-2 subscale scores showed no significant changes over time.

Discussion

Dronabinol therapy was well tolerated. During four weeks of exposure it induced a small but significant weight gain in the absence of severe adverse events. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:18–23)

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