The rationale for using atypical antipsychotics in anorexia lies not just in their potential side effect of weight gain, but in their ability to ameliorate the core disturbances in cognition, affect regulation, and motor activity seen in patients with anorexia nervosa, Dr. Kaplan explained.
"Anorexia is often underestimated as being a disturbance of motor activity," he said. "Our patients are hyperactive in the face of increasing emaciation, which you don’t see in any other condition."
Finally, workshop attendee Dr. Charles Price reported an acute response in a single patient with anorexia given modafinil and followed for 6 months. In a counterintuitive finding, the drug did not have the weight loss aspects observed with other stimulants.
"Basically, it cured her anorexia; now it is an ‘N’ of one," said Dr. Price, who is in private practice in Reno, Nev.
"It’s still worth writing up as a case report," Dr. Kaplan said to the agreement of the audience.
Dr. Kaplan reported having no conflicts of interest. Dr. Attia reported having received research support from Pfizer and Eli Lilly.