Controlled studies of the use of antidepressant medication in the treatment of bulimia nervosa provide evidence that such treatment is effective in reducing binge eating, purging, and levels of depression, at least in the short term. While the dropout rates from medication treatment are two-to-three times higher than those reported for cognitive-behavioral treatment, the efficacy of anti-depressant treatment for those able to tolerate medication side effects appears comparable to that of cognitive-behavioral therapy. The long-term efficacy of pharmacologic treatment is uncertain, although there is clinical evidence that when medication is stopped many patiens relapse. The optimal treatment period with medication has not yet been established. No adequate theory concerning the mechanism of action of antidepressants in bulimia nervosa has been established, although the serotonergic action of such drugs may directly affect carbohydrate consumption and binge eating. There is no evidence that the initial level of depression predicts outcome with antidepressant treatment, but it is suggested that such medication may decrease the prevalence of negative mood in the bulimic, hence enabling better control of binge eating.
ASJC Scopus subject areas
- Psychiatry and Mental health