Bulimia Nervosa and Antidepressant Drugs :: Causes of Bulimia, Eating Disorders

Bulimia Nervosa and Antidepressant Drugs WHAT IS BULIMIA NERVOSA? Bulimia nervosa afflicts mostly women (about 6% of adolescent girls, and 5% of college women). Most individuals with bulimia engage in compensatory activities such as vomiting, laxative abuse, strict dieting, and vigorous exercise (Alexander). PRIMARY SYMPTOMS OF BULIMIA The primary symptoms of bulimia are recurrent episodes of binge eating and compensatory measures to purge the calories. There is an excessive influence of the importance of the body and weight on one's self-evaluation (Negri). Symptoms of bulimia can be quite invisible because the bulimic can maintain normal weight. Occasionally, patterns of behavior may signal a problem: Do they restrict certain food? Do they eat in a ritualistic way? Are they overly concerned with diet? Do they weigh themselves every day? Do large quantities of food disappear from the refrigerator? Do they visit the bathroom soon after meals or frequently? (Negri). Some bulimics have a telltale scar on the first two knuckles of their hand from inducing vomiting. Some purge themselves up to several times a day. This can lead to serious medical consequences: dental cavities, electrolyte imbalances, disturbances in heart rhythm and dangerously low blood pressure (Negri). ANTIDEPRESSANTS AND THE TREATMENT OF BULIMIA Psychiatrist Linda Gochfield, who teaches brief psychotherapies to mental-health professionals, maintains that if people have a problem that responds to medication, that can be the briefest and most effective therapy of all (Davis). While bulimia often occurs with comorbid mood disturbances, the treatment benefit found for antidepressants in bulimia may not be merely alleviation of depressive symptoms; the increased serotonin levels also help reduce food intake. Looking at results of 14 studies of treatment of bulimia with antidepressants, it has been noted that administration to bulimics agents that increase the availability of serotonin virtually always produces better results than placebo, regardless of the presence or absence of depression (Alexander). There is now compelling evidence from double-blind, placebo-controlled studies that antidepressant medication is useful in the treatment of bulimia nervosa. What is less clear is which patients are most likely to benefit from antidepressant medications and how to best sequence the various therapeutic interventions available. The utility of antidepressant medications in bulimia nervosa has led to their evaluation in binge eating disorder. The limited information currently available suggests that antidepressant treatment may be associated with a reduction in binge frequency in obese patients with binge eating disorder, but does not lead to weight reduction.