CPG for Eating Disorders

PizotifenThis drug belongs to the group of antihistamines (whose effect is to block histamine H1 receptors).Aside from blocking the action of histamine H1 receptors in the brain, alleviating allergic reactionsymptoms, pizotifen is capable of blocking serotonin receptors in the brain, stimulating appetite.The following therapeutic indications have been approved in Spain: anorexia, thinness conditionedby psychic or “nervous” factors, weight deficit or loss, in puberty and senile patients.SibutramineAntidepressant. The following therapeutic indications have been approved in Spain:complementary therapy within a comprehensive weight management programme for patients withobesity (whose BMI is 30 kg/m 2 or more) and patients with overweight (whose BMI is 27 kg/m 2 ormore), who present other risk factors associated with obesity such as type 2 diabetes ordyslipidemia. It will be prescribed only to those patients who have not responded satisfactorily toan appropriate regimen that aims exclusively to tackle ponderal loss; that is, for patients whopresent difficulties in achieving or maintaining weight loss >5% in 3 months.Refeeding syndromeMetabolic disturbances and liquid and electrolyte imbalance with hypophosphatemia, cardiacinsufficiency, muscular weakness, immune and haematological dysfunction, digestive andnervous system disorders. It occurs when sudden refeeding is administered, with normal orexcessive caloric content, consisting mainly of carbohydrates. The best treatment for thissyndrome is to be aware of its existence and keep it in mind when refeeding a patient with aneating disorder. To tackle this syndrome, appropriate treatment will be based on the apparatus orsystem involved, modifying the route or load of deficitary micronutrients that are beingadministered (oral to parenteral, etc.).SulpirideSpecific dopamine D2 and D3 receptor antagonist anntipsychotic. The following therapeuticindications have been approved in Spain: diverse psychopathological pictures: neurosis,depression, neurotic somatizations, functional psychological disorders, psychosomatic syndromes,psychoasthenia, psychic involution of old age, gastrointestinal somatizations, vertigo. Inpsychiatry: acute psychotic, confusional, hallucinatory and delirious state, depressive state,schizophrenia, chronic delirium, autism, serious behavioural disorders, neurotic state withinhibition and depression and different cenestopathies.Induction-Dissonance TechniquesPrimary prevention psychosocial interventions that consist of performing exercises where eachparticipant targets one of his/her strongly-held belief and argues against this belief, to finddiscrepancies between both attitudes and promote effective change towards a new, betterstandpoint.CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS248