Psychopharmacologic treatment of bulimia nervosa.

Much recent research on bulimia nervosa has focused on the development of pharmacologic treatments for this disorder. Of the various classes of compounds which have been tested to date, only the antidepressants have displayed consistent and reproducible antibulimic efficacy. Double-blind, placebo-controlled trials have demonstrated that virtually all medications with antidepressant properties--tricyclic antidepressants, monoamine oxidase inhibitors, and atypical antidepressants, such as fluoxetine--significantly reduce the frequency of bingeing and purging in both depressed and nondepressed bulimics. However, the place of antidepressants in the overall treatment of bulimia nervosa remains unclear. Concerns about residual symptoms and long-term outcome, as well as the concomitant development of effective forms of psychotherapy, highlight the need for additional research to define an optimal therapeutic regimen for bulimia nervosa.