Antidepressants versus placebo for people with bulimia nervosa

The Combination of Levomilnacipran, Cognitive Behavior Therapy and Christian Based Self –Help Group in the Treatment of Bulimia Nervosa: A Case Report

“…The TCAs desipramine, amitriptyline and imipramine have also been useful in some patients with BN but due to their high risks of adverse effects including possible excessive weight gain and lethality in overdose they have not been recommended as initial pharmacological interventions [6,7,12]. The MAOIs antidepressants such as phenelzine which seemed to be beneficial in BN treatment its required dietary restrictions and its interactions with a wide variety of non-prescription medications usually used by BN patients make this class less appropriate for treatment of this condition [10]. Other antidepressant such as trazodone and mirtazapine, and mood stabilizers such as, topiramate, lithium ,valproic acid have also been used with some effectiveness in BN [6][7][8][12][13][14].…”

“…Despite its possible effectiveness, the antidepressant bupropion is contraindicated because of the association of its use with seizures in patients who purge and its anorexic side effects [9]. Medications that require dietary restrictions, such as the monoamine-oxidase inhibitors (MAOIs) are less appropriate in BN due to the medical complications associated with the diet restrictions nonadherence [10].…”

CYP2D6 polymorphism in patients with eating disorders

“…[11][12] Curiously, fluoxetine-recommended doses for the treatment of binge eating and purging in ED are higher (60 mg per day) than clinically recommended dosages for other disorders. 3,20 Further research is required to determine whether the use of higher doses of CYP2D6 substrates or normal doses under polytherapy in patients with ED might be related to a higher frequency of individuals with high CYP2D6 metabolic capacity.…”

Eating Disorders in Late-life

“…As to pharmacological treatment, evidence strongly support the efficacy of antidepressants (fluoxetine in particular) on core bulimic symptoms (binge eating and purging) and associated psychological features in the short-term [33]. Other studies demonstrated a certain efficacy of trazodone, fluvoxamine, desipramine [34][35] and of the anticonvulsant topiramate [36] The association of pharmacotherapy and psychotherapy or self-help seems to guarantee the best results, even if the limits pertaining the variety of the study designs facing this topic, with the consequential difficulties in replication, must be considered [37].…”