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Keywords:

  • Adolescence;
  • eating disorders;
  • anorexia nervosa;
  • prescribing;
  • pharmacology

Background:  Psychotropic drugs are not recommended for child and adolescent eating disorders, though they are used empirically for symptomatic treatment and co-morbid conditions. Little is known about rates of prescribing or the beneficial and adverse effects.

Objective:  To ascertain rates and outcomes of psychotropic drug prescribing in child and adolescent eating disorder services.

Method:  Retrospective case note study of eating disorder cases (= 308), seen in one year in seven specialist UK services, covering indications, response to treatment, beneficial and adverse effects.

Results:  Drugs were prescribed for 27%, (mainly anorexia nervosa), 12% before referral to specialist services. The most commonly prescribed drugs were fluoxetine and olanzapine, but 26 different drugs were used. The most common indications were depression, anxiety and ‘pseudo-psychotic’ concerns about weight. Drugs were generally well tolerated, but their effectiveness was uncertain.

Conclusions:  Non-specialists commonly prescribe psychotropic medication to this vulnerable group without reference to specialist services. Specialists prescribe regularly on empirical grounds, without apparent undue consequences, though these may be under-reported. A prospective clinical trial would further clarify risks and benefits.