Background: This program will cover novel medication approaches to eating disorders, across the age spectrum, as well as future directions from the UC San Diego psychopharmacologic experts.
Objectives: 1) Following this presentation, participants will be able to identify novel medication options for the treatment of eating disorders
2) Following this presentation, participants will be able to explain the various side-effects of medications.
3) Following this presentation, participants will be able to identify potential opportunities when medication augmentation may be beneficial
A. Intro: Eating disorders are complex, impacting individuals across the age spectrum and existing treatments fall short in helping the majority of individuals achieve full recovery. There is growing evidence of neurobiological deficits found in eating disorders and these targets can offer innovative approaches to our current treatment landscape. In this talk, we will present data from the UC San Diego Eating Disorder Programs including emerging psychopharmacologic treatments.
B. Mirtazapine and ARFID
1. Briefly describe ARFID
2. Present material from 14 patient chart review (ages 7-25, 8 males and 6 females) of mirtazapine to help with weight restoration and augment treatment in a partial hospital program
C. Aripiprazole and Anorexia
1. Altered dopamine system function is associated with diminished reward and increase anxiety and harm avoidance in patients with anorexia nervosa.
2. Present material of current chart review of >100 patients with AN and the use of Abilify with and without an antidepressant and the impact on weight restoration.
D. Ketamine and AN with depression
1. Describe case reports of IM Ketamine to target both depression and eating disorder symptoms.
E. Lamotrigine and emotional dysregulation in eating disorders
1. Describe current research study evaluating lamotrigine to target emotional dysregulation in patients with eating disorders
F. Looking to the future: Endocannabinoids and Anorexia
1. Describe overview of the endocannabinoid system and abnormalities found in anorexia nervosa
2. Present rational for use of THC and CBD to target key features of anorexia nervosa and describe a prospective research study to evaluate the safety and dosing of cannabinoid products.
G. Conclusion: There are many novel treatment options that are available and on the horizon that have the potential to help more patients with eating disorders achieve recovery and success with treatments. These medications target a specific neurobiological/physiologic disturbance that are found in patients with eating disorders that serve to augment existing therapeutic treatments.
Emily Gray M.D. is the medical director of the Pediatric and Adolescent Eating Disorder Program at the UCSD Eating Disorder Center for Treatment and Research and an Assistant Clinical Professor at the UCSD School of Medicine. She is board certified in adult and child/adolescent psychiatry and completed her undergraduate, medical school, and adult psychiatry residency training at the University of California, San Diego. She received specialty training in child and adolescent psychiatry at the Massachusetts General Hospital (MGH)/McLean Hospital and after graduating, became faculty at Harvard Medical School where she specialized in the treatment of eating disorders, child and adolescent psychiatry, and the overlap between psychiatric conditions and gastroenterology.
Dr Schwartz is the Clinical Director for UC San Diego Eating Disorders Programs. She provides education and clinical supervision to physicians, trainees and staff. She is a Clinical Professor at UC San Diego. She is involved in supervision and program development at the UC San Diego EDC. She has provided highly rated trainings and lectures for American Acaedmy of Family Physicians, AED, NEDA, psychiatry residents, OB Gyn physicians and nurses, She provides extensive clinical care for patients with eating disorders and the mental illnesses. She has been voted by her peers as one of the top doctors in San Diego
and
Mary Ellen Trunko, MD
Dr Trunko is the Medical Director of the UC San Diego Eating Disorders Program. She is double boarded in internal medicine and psychiatry. She has published in the area of pharmacological interventions for Eating Disorders. She has also done numerous CME/CEU medical consequences seminars/talks for medical and therapist groups. She has developed the UC San Diego Medical criteria for admission and monitoring for the Adult UC San Diego Eating Disorders program.She has also developed talks for parents/patients and trainees, including handouts on medical complications of eating disorders, which is used by our inpatient medical eating disorder unit,
