The pharmacological treatment of patients with an eating disorder (ED) often includes medications to treat their ED, comorbid mental health problems, malnutrition and the physical health problems resulting from it. The currently approved pharmacological treatment options for EDs are limited to fluoxetine for bulimia nervosa (BN) and – in some countries – lisdexamfetamine for binge eating disorder (BED). Thus, there are no approved pharmacological options for anorexia nervosa (AN), even though study results for olanzapine and dronabinol are promising. Topiramate might be an additional future option for the treatment of BN and BED. Selective serotonin reuptake inhibitors (SSRI), mirtazapine and bupropion could be considered for the treatment of comorbid unipolar depression. However, AN and BN are contraindications for bupropion. For ED patients with a manic episode, we recommend olanzapine in AN and risperidone in BN and BED; whereas for bipolar depression, olanzapine (plus fluoxetine) seems appropriate in AN and lamotrigine in BN and BED. Acute anxiety or suicidality may warrant benzodiazepine treatment with lorazepam. Proton-pump inhibitors, gastroprokinetic drugs, laxatives and hormones can alleviate certain physical health problems caused by EDs. Therapeutic drug monitoring, pharmacogenomic testing, a more restrictive use of “pro re nata” (PRN) medication, an interdisciplinary treatment approach, shared decision making (SDM) and the formulation of common treatment goals by the patients, their family or carers and clinicians could improve treatment success and safety. Novel genetic, immunological, microbiome and brain imaging research as well as new pharmacological developments like the use of psychedelics, stimulants, novel monoaminergic drugs, hormone analogues and drugs which enhance the effects of psychotherapy may extend our therapeutic options in the near future.

饮食失调 (ED) 患者的药物治疗通常包括治疗其 ED 的药物、合并的心理健康问题、营养不良和由此导致的身体健康问题。目前批准的 ED 药物治疗选择仅限于治疗神经性贪食症 (BN) 的氟西汀和 - 在某些国家 - 用于治疗暴食症 (BED) 的 lisdexamfetamine。因此，尽管奥氮平和屈大麻酚的研究结果很有希望，但尚无批准的神经性厌食症 (AN) 的药理学选择。托吡酯可能是治疗 BN 和 BED 的另一种未来选择。选择性5-羟色胺再摄取抑制剂（SSRI）、米氮平和安非他酮可考虑用于治疗共病的单相抑郁症。然而，AN 和 BN 是安非他酮的禁忌症。对于伴有躁狂发作的 ED 患者，我们推荐 AN 使用奥氮平，BN 和 BED 使用利培酮；而对于双相抑郁症，奥氮平（加氟西汀）似乎适用于 AN 和拉莫三嗪，适用于 BN 和 BED。急性焦虑或自杀可能需要用劳拉西泮进行苯二氮卓治疗。质子泵抑制剂、促胃动力药、泻药和激素可以缓解由 ED 引起的某些身体健康问题。治疗药物监测、药物基因组学测试、更严格地使用“pro re nata” (PRN) 药物、跨学科治疗方法、共同决策 (SDM) 以及由患者、他们的家人或护理人员和临床医生制定共同的治疗目标可以提高治疗的成功率和安全性。新型遗传学、免疫学、