Treating body dysmorphic disorder with medication: evidence, misconceptions, and a suggested approach

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Psychology

Background:

• Body dysmorphic disorder (BDD) is a prevalent, disabling condition associated with significant morbidity and mortality.
• Psychotropic medication and cognitive behavioral therapy (CBT) are established first-line treatments for BDD.
• Pharmacotherapy is particularly vital for patients with severe BDD symptoms and suicidal ideation.

Purpose of the Study:

• To provide a practical overview of pharmacotherapy for Body Dysmorphic Disorder (BDD).
• To review current research on BDD pharmacotherapy, emphasizing serotonin-reuptake inhibitors (SRIs).
• To discuss the recognition, diagnosis, and foundational therapeutic elements for BDD treatment.

Main Methods:

• Review of existing pharmacotherapy research for BDD.
• Focus on serotonin-reuptake inhibitors (SRIs) as the primary medication class.
• Discussion of practical treatment considerations including dosing, duration, and side effects.

Main Results:

• SRIs are considered the medication of choice for BDD.
• Pharmacotherapy can lead to substantial improvements in core BDD symptoms, psychosocial functioning, quality of life, and suicidality.
• Alternative pharmacotherapy strategies are discussed for cases where SRI monotherapy is insufficient.

Conclusions:

• Appropriate pharmacotherapy, particularly with SRIs, offers significant benefits for individuals with BDD.
• Addressing practical aspects of treatment and exploring adjunctive therapies are key for optimizing outcomes.
• Further research is needed to address knowledge gaps in BDD pharmacotherapy.