A double-blind placebo-controlled comparison of phenelzine and imipramine in the treatment of bulimia in atypical depressives

Abstract

Although antidepressants have been found to be superior to placebo in 12 of 14 studies, the relationship between improvement in the depressive diathesis and bulimia is unclear. In this study, the efficacy of placebo, imipramine, and phenelzine is examined in patients comorbid for atypical depression and bulimia. Greater improvement was observed for both depressive and bulimic symptoms with phenelzine than with either imipramine or placebo. Consistent with its poor antidepressant effects in atypical depression, imipramine seemed to have minimal efficacy for the bulimic symptoms of atypical depressives. These data suggest that the presence of bulimia does not alter the treatment response of atypically depressed patients. Furthermore, the data may suggest a link between depression and bulimia in atypical depressives. Demonstrating a statistical difference with a small sample suggests the effect size is robust, however conclusions are limited by a small sample size. 0 1994 by )ohnWiley & Sons, lnc.

Antidepressants versus placebo for the treatment of bulimia nervosa: a systematic review*

“…Two studies were multi‐centre, multinational [16,17], both comparing fluoxetine to placebo. Ten trials were conducted in the USA [18–27], two in Canada [28,29], one in the UK [30] and one in Norway [31]. Trials recruited outpatients seeking treatment ‘spontaneously’ from eating disorders clinics or programs, or included also volunteers for research recruited through advertisement.…”

Reactive mood and atypical depression in psychiatrically hospitalized depressed adolescents

“…Despite this, an inordinately high percentage of subjects diagnosed with bulimia had atypical depression. There is at least one report in the adult literature suggesting a link between depression and bulimia in atypical depressives (Rothschild et al, 1994), though there are contradictory reports (Hudson et al, 1987). Finally, atypical depressives were identified retrospectively.…”

Anorexia Nervosa and Bulimia Nervosa☆

“…Phenelzine, a monoamine oxidase inhibitor, is an antidepressant that is effective in the treatment of bulimia (Fallon et al, 1991;Rothschild et al, 1994;Walsh et al, 1984Walsh et al, , 1985Walsh et al, , 1988. Topiramate…”