HARCP Archives

Browse by article

Browse by volume

Heroin Addiction and Related Clinical Problems: 2014, 16, 3 (pages: 15 - 34)

The role of opioid system in Eating Disorders. Perspectives for new treatment strategies.

Rovai L., Maremmani A.G.I., Bacciardi S., Rugani F., Massimetti E., Gazzarrini D., Pacini M., Dell'Osso L., and Maremmani I.

Summary: Introduction: Growing evidence drawn both from observational and biological sources supports the hypothesis that eating disorders share the feature of inducing an alteration in the reward system, with a central role being played by opioid neuropeptides. Aims: To estimate i) epidemiological and clinical correlations between opioid use disorder and eating disorders; ii) the nature of the correlation between opioid medications, feeding behaviours and eating disorder symptoms; iii) the feasibility of using opioid medications in the management of eating disorders, especially anorexia nervosa, bulimia nervosa and binge eating disorder; iiii) the risk-benefit ratio of opioid medications compared with that of medications traditionally used to treat eating disorders. Methods: Overview after a thorough search on the “Scopus data base”. Results: We found few available data on the correlations between opiate addiction and eating disorders, whether on the epidemiological or the clinical plane. Opioid full and partial agonists seem to present a promising profile of effects that could be useful in treating anorexia nervosa. Opioid antagonists have been shown to be effective on both bulimia nervosa and binge eating disorders. Nalmefene should be preferred to naltrexone in bulimic patients of normal weight who are able to benefit from a double stabilization. Conclusions: Despite the scarcity of clinical and epidemiological data on the correlations between eating disorders and opiate addiction, evidence from both human and animal studies prompts the suggestion that opioid medications can play a far from negligible role in the treatment of eating disorders.