The (lack of) effect of alprazolam on eating behavior in anorexia nervosa: a preliminary report

Int J Eat Disord. 2014 Dec;47(8):901-4. doi: 10.1002/eat.22343. Epub 2014 Aug 19.

Abstract

Objective: Anxiety is a prominent symptom in anorexia nervosa (AN), and higher pre-meal anxiety has been associated with lower caloric intake. Yet, the causal relationship has not been assessed. We proposed that reducing anxiety with a short acting benzodiazepine would increase caloric intake among individuals with AN.

Method: In a randomized, double-blind, placebo controlled cross-over study, we administered alprazolam 0.75 mg to inpatients with AN (n = 17) and assessed caloric intake in a laboratory test meal. Within-subject differences in caloric intake, anxiety, and fatigue were compared between alprazolam and placebo days.

Results: Caloric intake did not differ on alprazolam versus placebo (t(15) = 1.72, p = .11). Alprazolam did not reduce anxiety, but was associated with increased fatigue.

Discussion: This study was not able to evaluate the causal role of anxiety in meal intake among individuals with AN, as alprazolam did not alter anxiety symptoms. These data further suggest that the therapeutic role for short-acting benzodiazepines in AN is likely limited.

Trial registration: ClinicalTrials.gov NCT01411813.

Keywords: alprazolam; anorexia nervosa; anxiety; benzodiazepine; eating behavior.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Alprazolam / pharmacology
  • Alprazolam / therapeutic use*
  • Anorexia Nervosa / drug therapy*
  • Anti-Anxiety Agents / pharmacology
  • Anti-Anxiety Agents / therapeutic use*
  • Cross-Over Studies
  • Double-Blind Method
  • Drug Administration Schedule
  • Energy Intake / drug effects
  • Female
  • Humans
  • Meals / drug effects
  • Middle Aged
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Anxiety Agents
  • Alprazolam

Associated data

  • ClinicalTrials.gov/NCT01411813