n eating Disorders Clinical Practice Guidelines (APA, 2023)

n American Psychiatric Association (2023, April 4). https://reference. medscape.com/viewarticle/990312

The following are some of the highlights of guidelines for the treatment of eating disorders, published in February 2023 by the American Psychiatric Association (APA) in the American Journal of Psychiatry

Assessment and Treatment

 Screening for the presence of an eating disorder should be part of an initial psychiatric evaluation.

 The initial evaluation of a patient with a possible eating disorder should include assessment of multiple factors, including but not limited to, patient’s history of height and weight, eating-related behaviors, food repertoire, weight control behaviors, and family history.

 The initial psychiatric evaluation of a patient with a possible eating disorder should identify co-occurring health conditions and psychiatric disorders.

Anorexia

 Patients with anorexia nervosa (AN) who require nutritional rehabilitation and weight restoration should have individualized goals for weekly weight gain and target weight.

 Adults with AN should be treated with an eating disorder–focused psychotherapy.

Bulimia

 Adults with bulimia nervosa (BN) should be treated with eating disorder–focused cognitive-behavioral therapy and prescribed a serotonin reuptake inhibitor.

Binge-Eating Disorder

 Patients with binge-eating disorder (BED) should be treated with eating disorder–focused cognitive-behavioral therapy or interpersonal therapy, either individually or in a group.

 Adults with BED who prefer medication or have not responded to psychotherapy alone should be treated with either an antidepressant medication or lisdexamfetamine.

n All interactions With Grapefruit (Citrus Paradisi, Pomelo, Toronja)

n Medscape. (2023, April 14). https://reference.medscape.com/drug/citrusparadisi-pomelo-grapefruit-344597#3

Grapefruit interferes with many medications, dietary supplement and physiologic conditions. It does this by disrupting various enzyme-mediated metabolic pathways. Medscape maintains a current interactive list of indication-specific dosing for citrus paradisi, pomelo, toronja (grapefruit). Based on FDA labeling and updates from medical literature, frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and cost information are available. The listing of medications that interact with grapefruit located in the Medscape article categorizes items into those which Medscape lists as contraindicated, produce minor to serious consequences, or require close monitoring. On Medscape, current details are available by simply selecting the individual item using the following link: https://reference.medscape.com/drug/citrusparadisi-pomelo-grapefruit-344597#3.

An additional resource listing of Medications that interact with Grapefruit: https://www.cmaj.ca/content/suppl/2012/11/26/cmaj.120951. DC1/grape-bailey-1-at.pdf.