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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0502

Hungry for happiness: moclobemide use in a treatment-resistant eating disorder

STARVED OF HAPPINESS – THE USE OF MOCLOBEMIDE IN TREATMENT-RESISTANT EATING DISORDER

In a case of an eating disorder unresponsive to multiple medications, electroconvulsive therapy, intravenous ketamine, and repetitive transcranial magnetic stimulation, marked improvement in both eating disorder and mood symptoms was observed with moclobemide initiated after a psychotropic medication washout.

The aim is to describe the use of moclobemide in a young woman with a treatment-resistant eating disorder, depression, and epilepsy. The method is a case report involving a review of medical records, psychiatric assessments, and treatment interventions, with informed consent obtained from the patient. The patient is a 25-year-old woman with no prior psychiatric history; she was initially diagnosed with anorexia nervosa in November 2018, and the diagnosis was subsequently revised to other specified feeding or eating disorder (OSFED), purging type. A diagnosis of idiopathic generalized epilepsy was added in January 2020, followed by the development of severe major depressive disorder, personality changes, suicidal ideation, and self-harming behaviors. She had at least 17 hospital admissions, most involving suicide attempts by medication overdose; treatments included antidepressants, antipsychotics, mood stabilizers, anxiolytics, electroconvulsive therapy, intravenous ketamine, and repetitive transcranial magnetic stimulation (rTMS), with limited overall improvement. Antidepressant trials included fluoxetine up to 50 mg, sertraline up to 50 mg, venlafaxine up to 225 mg, desvenlafaxine up to 100 mg, mirtazapine up to 37.5 mg, bupropion up to 150 mg, agomelatine up to 25 mg, trazodone up to 100 mg, escitalopram up to 20 mg, and vortioxetine up to 20 mg. During her July–September 2025 admission, vortioxetine 20 mg in the morning, escitalopram 20 mg at night, aripiprazole 15 mg at night, trazodone 50 mg at night, and alprazolam 0.25 mg as needed up to three times daily were gradually tapered and discontinued, and moclobemide 150 mg at night was initiated after a washout period of at least 9 days. Within one week of discontinuing the antidepressant combination, her affect was observed to be brighter, she was noted to smile, and she reported being able to experience a broader range of emotions and feeling "more human." Following discharge, her mood remained good on moclobemide 150 mg at night. The authors suggest that reducing polypharmacy and trialing moclobemide may be beneficial in treatment-resistant eating disorders.

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