Pharmacotherapy of eating disorders during transition from adolescence to adulthood
Abstract
Background The transition from adolescence to adulthood represents a critical developmental period associated with increased vulnerability to the persistence or worsening of eating disorders (EDs). Pharmacotherapy, though not first-line for most EDs, plays a complementary role in addressing core symptoms, psychiatric comorbidities, and medical complications. Objectives To summarize current evidence on the efficacy, safety, and clinical considerations of pharmacological treatments for anorexia nervosa (AN), bulimia nervosa (BN), and binge‑eating disorder (BED) during the transition age (approximately 16–25 years). Methods A narrative synthesis of clinical trials, recent systematic reviews and guideline recommendations with established or emerging evidence.. Results Evidence for pharmacotherapy in transitional-age patients remains limited. For AN, no medication has robust efficacy in weight restoration; however, atypical antipsychotics—particularly olanzapine—may support weight gain and reduce cognitive rigidity, though metabolic risks require close monitoring. In BN, selective serotonin reuptake inhibitors (SSRIs), especially fluoxetine at higher doses reduce binge–purge frequency and mood symptoms. BED pharmacotherapy is better supported: lisdexamfetamine demonstrates significant reductions in binge frequency, while topiramate reduce binge episodes and weight but with cognitive side‑effect risks. Comorbid anxiety, depression, and obsessive–compulsive symptoms often guide…
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