1
|
Merino D, Gérard AO, Destere A, Askenazy F, Dor E, Benoit M, Cherikh F, Drici MD. Iatrogenic triggers for anorexia nervosa and bulimia nervosa: A WHO safety database disproportionality analysis. Psychiatry Res 2023; 327:115415. [PMID: 37611327 DOI: 10.1016/j.psychres.2023.115415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/31/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
Eating disorders, characterized by abnormal eating, weight control behaviors or both include anorexia nervosa (AN) and bulimia nervosa (BN). We investigated their potential iatrogenic triggers, using real-world data from the WHO safety database (VigiBase®). VigiBase® was queried for all AN and BN reports. The reports were classified as `pediatric' or `adult' according to age. Disproportionality analyses relied on the Information Component (IC), in which a 95% confidence interval lower-end positivity was required to suspect a signal. Our queries yielded 309 AN and 499 BN reports. Isotretinoin was disproportionately reported in pediatric AN (IC 3.6; [2.6-4.3]), adult AN (IC 3.1; [1.7-4.0]), and pediatric BN (IC 3.9; [3.0-4.7]). Lamivudine (IC 4.2; [3.2-4.9]), nevirapine (IC 3.7; [2.6-4.6]), and zidovudine (IC 3.4; [2.0-4.3]) had the highest ICs in adult AN. AN was associated with isotretinoin, anticonvulsants in minors, and antiretroviral drugs in adults. In adults, BN was related to psychotropic and hormonally active drugs. Before treatment initiation, an anamnesis should seek out mental health conditions, allowing the identification of patients at risk of developing or relapsing into AN or BN. In addition to misuse, the hypothesis of iatrogenic triggers for AN and BN should also be considered.
Collapse
Affiliation(s)
- Diane Merino
- Department of Psychiatry, University Hospital of Nice, Nice, France; Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France
| | - Alexandre Olivier Gérard
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France; Université Côte d'Azur Laboratory of Molecular Physio Medicine (LP2M), UMR 7370, CNRS, Nice, France
| | - Alexandre Destere
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France; Université Côte d'Azur, Inria, CNRS, Laboratoire J.A. Dieudonné, Maasai team, Nice, France
| | - Florence Askenazy
- Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval Nice, France; CoBTek Laboratory, Université Côte d'Azur, 06000 Nice, France
| | - Emmanuelle Dor
- Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice, CHU-Lenval Nice, France; CoBTek Laboratory, Université Côte d'Azur, 06000 Nice, France
| | - Michel Benoit
- Department of Psychiatry, University Hospital of Nice, Nice, France
| | - Faredj Cherikh
- Department of Addiction, University Hospital of Nice, Nice, France
| | - Milou-Daniel Drici
- Department of Pharmacology and Pharmacovigilance Center of Nice, University Hospital Center of Nice, Nice, France.
| |
Collapse
|
2
|
Anorexia Nervosa as a Cause of Drug-Induced Thyrotoxicosis. CONSORTIUM PSYCHIATRICUM 2022. [DOI: 10.17816/cp182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The authors propose a case report analysis with a step-by-step exclusion of possible non-psychiatric medical causes of thyrotoxicosis in a young girl. The prolonged differential diagnosis eventually led to the diagnosis of drug-induced thyrotoxicosis due to anorexia nervosa in the patient. The analysis of the presented case report once again demonstrates the importance of a carefully curated medical history, including the psychiatric history, as well as a holistic and comprehensive analysis of all the clinical manifestations. We analyzed this case report of a patient with thyrotoxicosis due to anorexia nervosa in order to test the algorithm of differential diagnosis. All patient information was anonymized, and the patient gave informed consent to the submission of the case report for publication.
Collapse
|
3
|
Rayment D, Asfaha EA, Babiker A, Jaffa T. Hyperthyroidism during refeeding in anorexia nervosa. Int J Eat Disord 2012; 45:460-2. [PMID: 22006645 DOI: 10.1002/eat.20964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We report the second case of hyperthyroidism emerging during refeeding of a severely malnourished patient with Anorexia Nervosa (AN). METHOD Available patient records and biochemical data were evaluated. Previous case reports of hyperthyroidism in eating disorders were reviewed. DISCUSSION Refeeding can be associated with the onset of hyperthyroidism in patients with AN. AN and hyperthyroidism share a number of symptoms which can make identification of hyperthyroidism difficult. Lack of weight gain because of hyperthyroidism may be interpreted as noncompliance with refeeding treatment. The report shows that not taking antithyroid treatment can be employed as a method of weight control, highlighting the importance of extra consideration regarding treatment regimen and adequate support with medication compliance.
Collapse
Affiliation(s)
- Dane Rayment
- The Phoenix Centre, Ida Darwin Hospital, Cambridge, United Kingdom.
| | | | | | | |
Collapse
|
4
|
Hatch KA, Spangler DL, Backus EM, Balagna JT, Burns KS, Guzman BS, Hubbard MJ, Lindblad SL, Roeder BL, Ryther NE, Seawright MA, Tyau JN, Williams D. Towards a physiologically based diagnosis of anorexia nervosa and bulimia nervosa. Expert Rev Mol Diagn 2007; 7:845-57. [PMID: 18020913 DOI: 10.1586/14737159.7.6.845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Diagnosis of anorexia nervosa (AN) and bulimia nervosa (BN), while including such physiological data as weight and the reproductive status of the individual, are primarily based on questionnaires and interviews that rely on self-report of both body-related concerns and eating-related behaviors. While some key components of eating disorders are psychological and thus introspective in nature, reliance on self-report for the assessment of eating-related behaviors and nutritional status lacks the objectivity that a physiologically based measure could provide. The development of a more physiologically informed diagnosis for AN and BN would provide a more objective means of diagnosing these disorders, provide a sound physiological basis for diagnosing subclinical disorders and could also aid in monitoring the effectiveness of treatments for these disorders. Empirically supported, physiologically based methods for diagnosing AN and BN are reviewed herein as well as promising physiological measures that may potentially be used in the diagnosis of AN and BN.
Collapse
Affiliation(s)
- Kent A Hatch
- Department of Biology, Brigham Young University, Provo, UT 84602, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Fernández-Aranda F, Amor A, Jiménez-Murcia S, Giménez-Martínez L, Turón-Gil V, Vallejo-Ruiloba J. Bulimia nervosa and misuse of orlistat: two case reports. Int J Eat Disord 2001; 30:458-61. [PMID: 11746308 DOI: 10.1002/eat.1108] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Orlistat (tetrahydrolipstatin) is an intestinal lipase inhibitor that was approved recently for the management and treatment of obesity. This is the first report of the misuse of orlistat in two normal-weight purging bulimia nervosa (BN) patients. METHOD AND RESULTS We report two diagnosed cases of BN in two Spanish women who used orlistat as a purging mechanism after binge episodes. In both cases, the onset of the eating disorder was in adolescence. From the beginning, a restrictive diet, binging, and purging behavior (vomiting and using laxatives) were present. Both patients misused this substance as their only purging mechanism after every binge episode. CONCLUSION BN patients have used many substances and bizarre behaviors as purging mechanisms. Nevertheless, to the authors' knowledge, these are the first reported cases of orlistat misuse as the only purging mechanism in two BN patients.
Collapse
Affiliation(s)
- F Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain.
| | | | | | | | | | | |
Collapse
|
6
|
Donegà P, Gallerani M, Vigna GB, Fellin R. Reversible hyperthyroidism and cardiomyopathy caused by consumption of iodocasein. Am J Med Sci 2000; 320:148-50. [PMID: 10981492 DOI: 10.1097/00000441-200008000-00015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report the case of a 52-year-old woman with recent diagnosis of acute myocarditis and pericarditis, admitted for fever, tachycardia, and dyspnea upon exertion. Hematochemical parameters and instrumental examinations suggested iatrogenic hyperthyroidism and secondary dilated cardiomyopathy. Although gathering information about the medication used at home was initially difficult because of the patient's refusal to cooperate, she ended up by disclosing the regular assumption of an iodocasein drug. A complete and stable regression of the clinical picture was reached by suspending the iodine derivative and using cardiovascular drugs.
Collapse
Affiliation(s)
- P Donegà
- Department of Clinical and Experimental Medicine, University of Ferrara, Italy
| | | | | | | |
Collapse
|