NRNP 6665 Week 3 Assignment 1 Prescribing For Children and Adolescents Example 2

Prescribing for Children and Adolescents with Eating Disorders

Eating disorders are psychological illnesses characterized by unusual feeding habits. Types of eating disorders include bulimia, anorexia nervosa, avoidant restrictive food eating disorder, and binge eating disorder. The management of eating disorders in children and adolescents can be pharmacological or non-pharmacological (Hay, 2020). Fluoxetine is an FDA-approved drug that is used in pharmacological management. An off-label drug that can be used is olanzapine. Additionally, cognitive behavioral therapy can be used in non-pharmacological management.

The risk score for eating disorders will inform my decision for treatment. Risk assessment for eating disorders can be done using the Sick, Control, One, Fat & Food (SCOFF) Questionnaire. This is a 5-item questionnaire that asks if an individual induces vomiting, loses control over the amount they eat, if they have lost more than 15 pounds in three months, if they think they are fat, yet they are thin, and if food controls their life (Kutz et al., 2020). If two or more questions are answered positively, the patient is started on treatment.

According to Himmerich et al. (2021), fluoxetine is useful in managing eating disorders in that it alleviates anxiety or depression associated with the disease. The disadvantage of using fluoxetine is that it can cause insomnia, dry mouth, tremors, and weakness. Olanzapine also alleviates anxiety (Copur & Copur, 2020). However, it can cause respiratory depression, hyperglycemia, and anticholinergic effects like miosis.

The World Federation of Societies of Biological Psychiatry recommends antidepressants, antipsychotics, antiepileptics, and antihistamines to manage eating disorders. It also recommends combining pharmacological with non-pharmacological treatment. Fluoxetine is an antidepressant in the class of selective serotonin reuptake inhibitors. Olanzapine is a second-generation antipsychotic. These medications can be given along with psychotherapy.

References

 Çöpür, S., & Çöpür, M. (2020). Olanzapine in the treatment of anorexia nervosa: a systematic review. The Egyptian Journal of Neurology, Psychiatry, and Neurosurgery, 56(1), 1-7. https://doi.org/10.1186/s41983-020-00195-y

Hay, P. (2020). The current approach to eating disorders: a clinical update. Internal Medicine Journal, 50(1), 24–29. https://doi.org/10.1111/imj.14691

Himmerich, H., Kan, C., Au, K., & Treasure, J. (2021). Pharmacological treatment of eating disorders, comorbid mental health problems, malnutrition, and physical health consequences. Pharmacology & Therapeutics, 217, 107667. https://doi.org/10.1080/14740338.2018.1395854

Kutz, A. M., Marsh, A. G., Gunderson, C. G., Maguen, S., & Masheb, R. M. (2020). Eating disorder screening: a systematic review and meta-analysis of the SCOFF diagnostic test characteristics. Journal Of General Internal Medicine, 35(3), 885–893. https://doi.org/10.1007/s11606-019-05478-6


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