As with many psychiatric issues, eating disorders are the subject of many medication trials, but treatment success, particularly with anorexia nervosa, is spotty at best. Part of the problem is that it's difficult to predict how a certain drug will affect a given person. To improve our accuracy in prescribing medications, some are turning to a new technology called "referenced Electroencephalography (EGG)" or rEEG.
Referenced EEG Automates Eating Disorder Drug Prescriptions
An electroencephalogram is a recording of a person's brainwave activity. The idea behind referenced EEG is simple: record EEG data for several thousand patients and monitor how different drugs work for different categories of electrical brain signatures. Once patterns emerge, use the data to match new patients' brain signatures to those that have been recorded. Then prescribe the drug or drugs that have worked best in the past.
Researchers are beginning to apply this technique to eating disorder patients, and early results are very encouraging.
How Referenced EEG Works for Eating Disorders
A study investigated the use of rEEG with hard-to-treat eating disorder patients. They chose eight people -- four with anorexia nervosa, two with bulimia nervosa and two with eating disorder not otherwise specified (EDNOS). All had experienced outpatient treatment and had been prescribed medication before. Further, over the previous two years, the eight patients had 32 hospitalizations and over 600 days of inpatient treatment. For each patient, a combination of 2 to 3 drugs was selected based on predictions of effectiveness from rEEG.
If the results are any indication, rEEG is very promising. All patients experienced dramatic improvements in hospitalizations (only 6 hospitalizations covering 21 cumulative days of inpatient treatment in the follow-up period) and in symptoms of disordered eating over the follow-up period.
These results are particularly striking in the case of anorexia. It is normally very difficult to treat anorexia with medications when the disorder is severe. In many cases, the body has difficulty metabolizing drugs, so they don't work as they do for others.
Limitations of the Study
Though hopeful, this study is preliminary. It did not use a control group for comparison (though all patients received psychotherapy and nutritional counseling, as other patients would), and eight patients is a very small sample size. Further, results are not broken down for the various eating disorder types (partially due to the small number of patients). Also, follow-up monitoring was not consistent: Some were followed for less than a year, while others were monitored for over three years.
If You're Interested in Referenced EEG
There are a few doctors offering treatment via rEEG (mostly in North America). This tiny number of practitioners is a reminder that the technology is very new.
One question that arose as I studied the early results of rEEG is whether it will be approved by the FDA. CNS Response is already suggesting that rEEG can improve the FDA's process of conducting clinical trials in the future, so they are apparently assuming that the FDA will welcome rEEG with open arms. Of course, that could also be a statement made for marketing purposes.
In short, proceed with hope, but with such a new medical tool, always proceed with caution.
Source:
Greenblatt J, Sussman C, Jameson M, and Kasumova G. Referenced-EEG® guided medication predictions in treatment refractory eating disorder patients. Poster presentation. Accessed 17 June 2008.
