Abstract
The role of electrophysiological abnormalities in the genesis of bulimia nervosa remains controversial. Earlier findings of abnormal surface electroencephalograms in patients with bulimia and reports of bulimic patients responding to treatment with anticonvulsant medications have generally not been supported by subsequent studies. However, the apparently elevated rate of tonic-clonic seizures in bulimic patients treated with the antidepressant bupropion has not been adequately explained. To further clarify this issue, we obtained brain electrical activity mapping studies (BEAMs) in 12 patients with DSM-III-R bulimia nervosa. In ten patients, repeat BEAMs were obtained 4 to 6 weeks later while the patient was treated with either trazodone (n = 6) or placebo (n = 4). Five (42%) of the 12 bulimic patients displayed definitely abnormal pre-treatment BEAMs, and many of the other seven displayed at least some abnormalities when individually compared to an age-matched control group. In the ten patients who received two BEAMs these abnormalities were stable over time. Treatment with trazodone did not significantly affect these abnormalities. The clinical and theoretical significance of these findings remains unclear.
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