Preview

Rational Pharmacotherapy in Cardiology

Advanced search

HYPERPHAGIA REACTIONS WITHIN EATING DISORDERS. CLINICAL FEATURES AND THERAPY

https://doi.org/10.20996/1819-6446-2014-10-2-190-194

Full Text:

Abstract

Aim. To evaluate clinical features of hyperphagia reactions, their significance in attraction abnormities within eating disorders and treatment options for these conditions with escitalopram.

Material and methods. Mental state of 39 women (age 19-50 years) with psychogenic overeating and obesity (body mass index of 30 to 53 kg/m2) was studied. Patients were admitted to the Institute of Nutrition of the Russian Academy of Medical Sciences. Diagnostic criteria for International Classification of Diseases, 10th edition, as well as Eating Disorder Inventory (EDI), Hospital Anxiety and Depression Scale (HADS) and Ferreri Anxiety Rating Diagram (FARD) were used for syndrome qualifications. Patient Global Impression of Change was also studied using a 4-point scale of results (excellent, good, fair, and negative).

Results. Clinical features of hyperphagic reactions were found. Escitalopram treatment course was completed with excellent and good results in 80% of patients. 50%-reduction in HADS score for anxiety was found in 74% of patients, for depression – in 63%, and for Ferreri scale – in 68% of patients. Escitalopram promoted more intensive body weight loss: 11% vs 8% of baseline weight in active and control groups, respectively. Adverse events occurred only in 7 (36%) patients; they were transient and did not require therapy discontinuation.

Conclusion: Significant differences of premanifest disorders were often observed in patients history. Escitalopram in these patients showed efficacy in improvement of both mental and somatic symptoms of anxiety. It decreased dependence on food as a factor mitigating affect and stress, thus provided better results in body weight reduction.

About the Author

O. A. Gladyshev
Mental Health Research Center of the Russian Academy of Medical Sciences, Moscow
Russian Federation


References

1. Obesity and overweight. WHO Fact sheet N°311. Updated March 2013. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed by: 15.04.2014

2. World Gastroenterology Organisation global guideline: obesity. Milwaukee (WI): World Gastroenterology Organisation (WGO); 2011

3. Wong RJ, Chou C, Ahmed A. Long Term Trends and Racial/Ethnic Disparities in the Prevalence of Obesity. J Community Health. 2014 Apr 9. [Epub ahead of print]

4. Saydah S, Bullard KM, Cheng Y Trends in cardiovascular disease risk factors by obesity level in adults in the United States, NHANES 1999-2010. Obesity (Silver Spring). 2014Apr 15. doi: 10.1002/oby.20761. [Epub ahead of print]

5. Ayyad C, Andersen T. Long-term efficacy of dietary treatment of obesity: a systematic review of studies published between 1931 and 1999. Obes Rev. 2000 Oct;1(2):113-9.

6. Glazer G. Long-term pharmacotherapy of obesity 2000: a review of efficacy and safety. Arch Intern Med. 2001 Aug 13-27;161(15):1814-24.

7. Pascual JM, Rodilla E. Indications of efficacy of bariatric surgery in the management of morbid obesity. Rev Clin Esp. 2006 Sep;206(8):385-7.

8. Mazo VK, Bogdanov AR, Gladyshev OA et al. Development of approaches to assess the impact of diet therapy on emotional state and adaptive capacity of patients with diseases of the cardiovascular system and obesity. QuestionsDietetics 2012; 2 (2): 10-13. Russian (Мазо В.К., БогдановА.Р., Гладышев О.А. и др. Разработка подходов по оценке влияния диетотерапии на психоэмоциональное состояние и адаптационные возможности больных с заболеваниями сердечно-сосудистой системы и ожирением. Вопросы диетологии 2012; 2(2): 10-13).

9. Tsirkin SJ, Babin AG, Gladyshev OA. Bulimia nervosa: criteria and typology. Social and Clinical Psychiatry 2000, 10 (1): 68-72. Russian (Циркин С.Ю., Бабин А.Г., Гладышев О.А.Нервная булимия: критерии и типология. Социальная и Клиническая Психиатрия 2000;10(1): 68-72).

10. Gladyshev OA, Isakov VA, Shahovskaya AK. Diet therapy of patients with anorexia nervosa and eating disorders in a hospital. Matters of Nutrition 2011; 80 (1):39-45. Russian (Гладышев О.А., Исаков В.А., Шаховская А.К. Диетотерапия больных, страдающих нервной анорексией и нарушением пищевого поведения, в условиях стационара. Вопросы Питания 2011; 80(1):39-45).

11. Belyanchikova MA, Gladyshev OA, Bobrov AE. Atarax and other outpatient лечении тревожных расстройств. Journal of Neuropathology and Psychiatry im.S.S.Korsakova 1998; (2) :31-3. Russian (Белянчикова М.А., Гладышев О.А.. Бобров А.Е. и др. Атаракс в амбулаторном лечении тревожных расстройств. Журнал Невропатологии и Психиатрии им.С.С.Корсакова 1998;(2):31-3).

12. Abramova LI, Arsenyev TB, Panova NL, Shvedova AK. Cipralex (escitalopram): therapeutic efficacy in post-schizophrenic (postpsychotic) depression. Psychiatry 2010; (2) :1-10. Russian (Абрамова Л.И., Арсеньева Т.Б., Панова Н.Л., Шведова А.К. Ципралекс (эсциталопрам): терапевтическая эффективность при постшизофренических (постпсихотических) депрессиях. Психиатрия 2010; (2):1-10).

13. Zigmond A.S., Snaith R.P. The Hospital Anxiety and Depression scale. Acta Psychiatr Scand 1983; 67: 361-70.

14. Ferreri M., Von Frenckell R., Mirabel V. et al. Une nouvelle echelle d evolution quantitative et qualitative de l anxiety, le F. A. R. D. Encephale 1988;14(5): 385-93.

15. Zaletova T., Shcherbakova M., Gladyshev O. To determine the level of anxiety symptoms in patients with obesity. 5-th International Congress on Prediabetes and the Metabolic Syndrome scheduled to take place in Vienna, Austria, April 18-20, 2013.

16. Starostina EG Obesity as a psychosomatic illness. Obesity and Metabolism 2005; (5): 18-23. Russian (Старостина Е.Г. Ожирение как психосоматическое заболевание. Ожирение и Метаболизм 2005; (5): 18-23).


Review

For citations:


Gladyshev O.A. HYPERPHAGIA REACTIONS WITHIN EATING DISORDERS. CLINICAL FEATURES AND THERAPY. Rational Pharmacotherapy in Cardiology. 2014;10(2):190-194. (In Russ.) https://doi.org/10.20996/1819-6446-2014-10-2-190-194

Views: 1082


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)