Drug and group treatments for bulimia/bulimia nervosa.

This paper is a review of all published studies using drug or group treatments. Both open uncontrolled and controlled trials are reviewed. There have been six open uncontrolled studies of drug treatment and eight placebo controlled double-blind trials of antidepressants. Four other studies using anticonvulsants or agents such as fenfluramine are also reviewed. Seven uncontrolled reports of group treatment for bulimia are presented and six where group treatment has been compared with other treatments or evaluated against a control group. It is our assessment that neither group nor drug treatments have at present been shown to be as effective as individual psychotherapy, but that both are clearly more efficacious than placebo control and that on balance when weighing cost against efficacy, group treatment of a relatively brief kind with long follow-up is the most effective treatment intervention.