FLUOXETINE AFTER WEIGHT RESTORATION IN ANOREXIA NERVOSA

描述（改编自申请人的摘要）：神经性厌食症（AN）是一种 严重精神障碍，发病率高，终生 死亡率可以说与任何精神疾病相关的死亡率一样高。一 这种疾病预后不良的主要原因是高发病率， 初次治疗成功后复发。AN患者经常 表现出其他精神疾病的症状，如重度抑郁症， 强迫症，对治疗反应良好， 药因此，令人惊讶的是，AN的药物治疗 一直不成功。几乎所有的对照试验 在治疗的初始阶段进行药物治疗，当 患者体重不足。可能药物的作用有限， 在疾病阶段，由于生理和 饥饿的神经化学效应因此，探讨 AN患者在初始治疗后的药物效用 扭转了饥饿的严重影响。 当前应用程序的目标是确定SSRI是否 与安慰剂相比，氟西汀可降低复发率， 心理和行为恢复后的初始治疗AN。在 为了回答这个问题，一个两个地点（纽约和多伦多），四年 R01的研究。80例AN患者， 在住院或重症监护室成功完成初始治疗 门诊项目将被随机分配接受氟西汀或安慰剂 在双盲条件下持续12个月，同时接受适当 心理治疗结果将根据维持情况进行评估 体重和AN特征性精神病理症状的减轻。

DESCRIPTION (Adapted from the Applicant's Abstract): Anorexia nervosa (AN) is a serious psychiatric disorder with substantial morbidity and a lifetime mortality arguably as high as that associated with any psychiatric illness. A major contributor to the poor prognosis of this illness is the high rate of relapse that follows successful initial treatment. Patients with AN often exhibit symptoms of other psychiatric disorders, such as major depression and obsessive compulsive disorder, which respond favorably to treatment with medication. It is surprising therefore that medication treatment for AN has been consistently unsuccessful. Virtually all of the controlled trials of medication have been conducted during the initial phase of treatment, when patients are underweight. It is possible that medications are of limited utility during the phase of illness because of the physiological and neurochemical effects of starvation. Therefore, it may be useful to explore the utility of medication among patients with AN after initial treatment has reversed the acute effects of starvation. The goal of the current application is to determine whether the SSRI fluoxetine, compared to placebo, reduces the rate of relapse and enhances psychological and behavioral recovery following initial treatment for AN. In order to answer this question, a two-site (New York and Toronto), four year collaborative R01 study is proposed. Eighty patients with AN who have successfully completed initial treatment in an inpatient or intensive outpatient program will be randomly assigned to receive fluoxetine or placebo for 12 months under double-blind conditions while receiving appropriate psychological treatment. Outcome will be assessed on the basis of maintenance of weight and reduction in psychopathological symptoms characteristic of AN.