Fluoxetine in the treatment of anxiety, depressive symptoms, and eating-related symptoms in bulimia nervosa

Abstract

Fluoxetine, a selective serotonin reuptake inhibitor, was compared at a dose of 60 mg once daily with placebo in an 8-week double-blind study of 50 bulimia nervosa patients. Efficacy was evaluated by semistructured interviews and self-ratings. Twenty-two patients in the fluoxetine group and 24 in the placebo group completed the study. The ratings of the subjects on the 21-item Hamilton Depression Rating Scale (p=0.051, ANOVA with repeated measures) and on the depression subscale (p=0.0003) improved significantly more with fluoxetine than with placebo. The efficacy of fluoxetine emerged rapidly. By the 4th week the ratings of the subjects on the 21-(p=0.0062, Mann-Whitney U test) and 17-item (p=0.030) Hamilton Depression Rating Scale and on the depression subscale (p=0.0002) improved significantly more with fluoxetine than with placebo. Clinician-rated anxiety (p=0.0004, ANOVA with repeated measures) and self-rated anxiety (p=0.0004) were significantly reduced with fluoxetine. Fluoxetine was superior in increasing the feeling of energy: this effect emerged already by the 4th week of treatment (p=0.038, Fisher's two-sided exact test). Fluoxetine also reduced eating-related symptoms, and the patients taking fluoxetine lost weight; in contrast, patients taking placebo gained weight (p=0.023, ANOVA with repeated measures). Fluoxetine has several favorable effects on bulimic symptoms, which emerge within 4 weeks of treatment.

Key Words:

• Anxiety
• Bulimia nervosa
• Depression
• Fluoxetine