The pharmacologic treatment of eating disorders.

There is substantial evidence that antidepressant medication is significantly superior to placebo in the short-term treatment of bulimia nervosa. Further work is needed to determine long-term outcome of patients with bulimia nervosa who receive antidepressant treatment, the role of antidepressants in patients who are receiving psychological treatment, and the utility of sequential medication trials. In the treatment of anorexia nervosa, there is little evidence that psychotropic medications, including antipsychotics, antidepressants, and cyproheptadine, are of significant benefit to most patients who are in the acute phase of treatment and are receiving behavioral treatment to promote weight gain. There is preliminary evidence that antidepressant medication, specifically fluoxetine, may be useful in preventing relapse in weight-recovered patients with anorexia nervosa, but this has not yet been documented in randomized, double-blind, controlled trials.