Psychopharmacological Prescribing Patterns Among Italian Adolescents With Anorexia Nervosa: Exploring Real-World...

Area of Science:

• Child and Adolescent Psychiatry
• Clinical Psychology
• Psychopharmacology

Background:

• Anorexia nervosa (AN) is a complex eating disorder with significant psychiatric comorbidities.
• Understanding psychopharmacological prescribing patterns in adolescent AN is crucial for effective treatment.
• Real-world data on medication use in adolescent AN is limited, especially in diverse clinical settings.

Purpose of the Study:

• To compare psychopharmacological prescribing patterns in Italian adolescents with AN versus psychiatric controls.
• To determine if AN diagnosis independently predicts medication use, accounting for comorbidities.
• To investigate patterns of specific drug classes and polypharmacy in adolescent AN.

Main Methods:

• A cross-sectional cohort study of 298 female adolescents (12-18 years) from Italian Child and Adolescent Neuropsychiatry services.
• Participants were categorized into AN (n=149) and control (n=149) groups based on DSM-5/DSM-5-TR criteria.
• Multivariable logistic regression analyzed associations between diagnosis, medication use, and polypharmacy, adjusting for comorbidities and site differences.

Main Results:

• Unadjusted analyses showed higher psychotropic medication use in controls.
• AN diagnosis was not independently linked to overall psychotropic, antipsychotic, or antidepressant prescriptions.
• Adolescents with AN had significantly higher odds of receiving benzodiazepines (aOR=2.76) and polypharmacy (aOR=2.37).
• Polypharmacy was also associated with psychotic, personality, and depressive disorders.

Conclusions:

• Psychopharmacological treatment for adolescent AN is largely influenced by co-occurring psychiatric conditions.
• Increased benzodiazepine use and polypharmacy in AN suggest specific clinical needs.
• Further research is needed to develop evidence-based, disorder-specific pharmacological guidelines for adolescent AN.