Antidepressants versus placebo for the
treatment of bulimia nervosa: a systematic review
by
Bacaltchuk J, Hay P, Mari JJ
Federal University of Sao Paulo-
Paulista School of Medicine,
Brazil.
bacaltc@ibm.net
Aust N Z J Psychiatry 2000 Apr; 34(2):310-7

ABSTRACT

OBJECTIVE: The objective of this study was to valuate the effectiveness, tolerability and acceptability of various classes of antidepressants compared with placebo in the treatment of bulimia nervosa. METHOD: A meta-analysis including 16 randomised controlled trials and 1300 bulimic patients was performed. Dichotomous outcomes were analysed by calculating relative risks, and continuous outcomes by calculating effect sizes. Methodological quality, heterogeneity in the results and selective publication were assessed. RESULTS: Short-term remission in bulimic symptoms was statistically more likely on antidepressants than placebo (Relative Risk=0.88, 95% CI=0.83-0.94, p<0.0001). Drop-out rates were high but no statistical difference was found between treatment groups (34.6% and 31.4% for drug and placebo; RR=1.03, 95% CI=0.80-1.32, p=0.8). No difference in efficacy could be demonstrated among different classes of antidepressants. CONCLUSIONS: The use of a single antidepressant agent was clinically effective for the treatment of bulimia nervosa when compared with placebo, with an overall greater remission rate and a higher rate of drop-outs. No differential effect regarding efficacy and tolerability among the various classes of antidepressants could be demonstrated.

Bulimia
Serotonin
Slimming drugs
Eating disorders
Body dysmorphic disorder
Fluvoxamine for depression
Fluvoxamine and endorphins
Fluvoxamine for social phobia
Fluvoxamine for depression and anxiety

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