Drug therapy for anorexia nervosa: antianxiety medications

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Drug therapy for anorexia nervosa: antianxiety medications
DRUG THERAPY FOR ANOREXIA NERVOSA: ANTIANXIETY MEDICATIONS

When an anorexic is highly anxious, anti-anxiety medicines can be more helpful than the antipsychotics. Anxiety can take many forms: fear of fatness; concern about living up to "other people's expectations" about thinness; worry about criticism from family and friends. Anorexics have deep fears about body size and shape, and may feel traumatized by bodily changes during puberty.
Anxiety only feeds these fears and makes them worse. For example, a girl may feel that eating anything at all will make her fat. She thus relieves her anxiety by cutting out virtually all foods from her diet. What's more, an anorexic is often perfectionistic by nature. She may grow anxious if something is amiss or out of place in her otherwise tightly structured life.
Anti-anxiety medications are sometimes used for the small minority of anorexic patients who have such extreme anxiety about eating that they are unable to function even in a supportive environment. Anti-anxiety medications that are "short acting," such as lorazepam or oxazepam, seem to be tolerated better than the "long-acting" medications such as diazepam (Valium). Side effects can include sedation and dizziness; anorexics are often highly sensitive to such feelings. As we saw earlier, there is also a serious risk of addiction.
I find that anxiety-ridden patients tend to tolerate these medications better and experience fewer side effects than they do with antidepressants. If a patient has extreme anxiety at mealtime, I may consider offering her a short-acting medicine such as lorazepam or oxazepam.

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