Treatment of anorexia nervosa

Abstract

Treatment of anorexia nervosa integrates psychiatric and medical aspects. Elements of analytically oriented (not true psychoanalysis) and behavioral forms of psychotherapy are utilized. Emphasis should be placed in the setting, patient-therapist relation, and alliance with the family. Weight gain is the gauge and one of the goals of the therapy, having in mind that as it increases anxiety may be generated. From a behavioral point some restrictions are indicated. Antipsychotic (or neuroleptic) and antidepressant drugs should be used. Haloperidol is the drug of choice among antipsychotics while amitriptyline is usually preferred as antidepressant. General medical measures include adequate nutritional support, limitation of physical activity, eventual supplementation with iron, folic acid and vitamin B12. Estrogen therapy associated to progestins, calcium and vitamin D should be considered to prevent osteopenia.