Eating
Disorders
Antidepressant Shows Early Promise Against Bulimia
(Aug 12, 2004) -- Treatment with the
antidepressant Zoloft
may help women with
bulimia curb their
disordered eating behavior, preliminary research suggests.
The study of 18 women who took the drug for eight weeks found that after
treatment, most had fallen below the threshold for "probable"
bulimia on a standard questionnaire. And many were able to stop the cycles
of bingeing and purging that mark the disorder.
The study, published in the International Journal of Eating Disorders,
received partial funding from Zoloft maker Pfizer, Inc.
People with bulimia, most often young women, go through repeated episodes of
binge-eating followed by purging, through vomiting or abuse of laxatives; some
fast or excessively exercise to counter the binge.
Treatment typically involves counseling to address the distorted body image
and other
destructive thoughts and feelings that underlie the disorder. The
antidepressant Prozac, which was approved in the U.S. in 1996 to treat bulimia,
is another treatment option.
Like that drug, Zoloft -- known generically as sertraline -- is a selective
serotonin reuptake inhibitor, or SSRI, but it has not received much attention as
a potential bulimia therapy, according to the authors of the new study.
They found that after eight weeks on Zoloft, only two of the 14 women who
completed the study remained above the threshold for probable bulimia, as did
the four women who dropped out before completing treatment. Half of those who
finished the study had stopped bingeing and purging by the end.
The most common side effects of the drug were diarrhea, headache, jitteriness
and nausea.
Despite the drop in symptoms, the study does not prove Zoloft was effective
for these patients because there was no comparison group that got a placebo, or
inactive treatment.
All of the women knew they were receiving the antidepressant, so the
improvement in their symptoms may have been the result of their expectations
that they would get better, lead study author Dr. Denise M. Sloan told Reuters
Health.
What's needed now is a "double-blind" placebo-controlled study where neither
the patients nor the researchers know who's getting the drug and who's on the
placebo, said Sloan, a professor of psychology at Temple University in
Philadelphia.
Although Zoloft works in a similar manner as Prozac -- acting on the brain
chemical serotonin -- the various
SSRI drugs are not identical and may not have
the same effects against bulimia, according to the researchers. Sloan said there
is reason to believe that some SSRIs might work better than others, because the
compounds have different molecular structures that may act on the central
nervous system in different ways.
Exactly why SSRI antidepressants are effective for some bulimics is unclear.
Depression often goes hand-in-hand with the eating disorder, and women in the
current study saw an improvement in
depression symptoms. However, Sloan said it
does not appear that SSRIs help simply by relieving bulimia patients'
depression.
SOURCE: International Journal of Eating Disorders.
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