On the surface, the logic seems sound. Since one of the suspected causes of bulimia is depression, why not give an anti-depressant to see if the behavior improves? In fact, there is evidence that SSRIs selective serotonin reuptake inhibitors are useful in treating bulimia. Psychiatric and Mental Health Congress. So why not Wellbutrin? In four out of 69 patients with bulimia treated with Wellbutrin, gran mal seizures were the unfortunate result.
A gran mal seizure is a medical emergency and can be fatal. The manufacturer mentions this in their literature :. Interestingly, the positive effects of the medication were sustained at 9 to month follow-up. MAOIs e. However, owing to common and potentially dangerous adverse events associated with their use, these medications are generally reserved for refractory cases and for use by psychiatrists with considerable eating disorder expertise.
B upropion Wellbutrin has also been found helpful in controlling bulimia nervosa symptomology, but has been associated with an increased risk for seizures, and is contraindicated for the treatment of bulimia nervosa and other eating disorders.
It is important to recognize that the use of antidepressants includes significant risks associated with use during pregnancy, possible risk of increased suicidality in adolescents and young adults, risk of manic symptoms in patients with bipolar disorder, and possible weight change as a side effect.
Prior to initiating pharmacotherapy, patients should be counseled regarding these risks and carefully screened for additional risk factors and comorbidities. The antiepileptic drug, topiramate Topamax , has been found to be effective for bulimia nervosa treatment in two separate randomized, placebo-controlled studies. Topiramate was superior to placebo in reducing the frequency of binge and purge days, and was also associated with reduced body weight.
The FDA recently approved topiramate for migraine prevention in adolescents. Pharmacotherapy for bulimia nervosa may also be guided by the presence of co-occurring conditions. Antidepressants may be especially helpful for bulimia nervosa patients with a depressive or anxiety disorder.
Patients with a seasonal pattern to depressive symptoms and bulimia may benefit from light therapy: 10, lux for 30 minutes each morning. ADHD medicines, like atomoxetine Strattera , or a psychostimulant like lisdexamfetamine Vyvanse have been shown to be helpful for control of eating disorder symptoms in patients with binge eating disorder BED.
With careful monitoring, these drugs can also be helpful to some patients with bulimia nervosa and comorbid ADHD. Anti-addiction or anti-craving drugs may prove helpful for some patients with co-occurring substance-use disorders.
The opiate antagonist Naltrexone Revia , at supratherapeutic doses e. Although Naltrexone use carries the risk of liver damage, when used with consistent assessment for response and careful laboratory monitoring of liver function, the potential benefit of this medicine could outweigh the risk when used for select patients. No empirical data are available for treating bulimia nervosa patients with bipolar disorder. In bipolar patients with obesity or fear of taking a mood stabilizer because of possible weight gain, agents effective in mania or bipolar depression that have minimal effects on weight may be considered, such as the second-generation antipsychotics like lurasidone Latuda or aripiprazole Abilify.
A weight-neutral antiseizure medication, lamotrigine Lamictal , can be considered for bipolar patients with bulimia nervosa who have a predominantly depressive presentation.
For bipolar patients with bulimia nervosa who have mood-stabilizing responses but continue to have binge eating episodes, augmentation with topiramate or careful use of antidepressants may be considered. When treating bulimia nervosa patients with pharmacotherapy, a multidisciplinary team approach is considered best care.
It is important that, when available, psychological strategies are simultaneously implemented and optimized. Thus, psychotherapy should be strongly recommended to psychopharmacology patients, even those who initially refuse psychotherapy.
During treatment with psychotropic medications, close monitoring is needed for the onset of adverse effects and to gather objective information about response to treatment e. Several smartphone apps have been developed to support clinical data collection and HIPPA-compliant transfer of information between the patient and the team.
These apps can also track, correlate, and graph the incidence of these behaviors with changes in mood, anxiety, and use of non-pharmacologic coping strategies for stress and eating disorder urges. Following encouraging treatment outcomes for antidepressants like Paxil, Prozac, and Zoloft, Wellbutrin was tested on a sample group of 69 patients with bulimia nervosa.
However, this limited trial was a disaster, with 4 of the 69 patients suffering one or more Wellbutrin-related grand mal seizures. During a grand mal seizure, patients typically experience violent muscle contractions and a temporary loss of consciousness. Without immediate emergency care, a grand mal seizure can be fatal. Unfortunately, even though there is well-documented evidence that taking Wellbutrin lowers the seizure threshold in people with bulimia nervosa, the drug is still mentioned as a viable treatment option across a range of eating disorder discussion forums.
Eating disorders, especially disorders like bulimia and anorexia nervosa, are complex conditions, encompassing both compulsive behavioral outcomes and debilitating physical symptoms. In most cases, medication in isolation is not an effective treatment option for bulimia nervosa. For more successful treatment, experts will likely recommend the use of safe, prescribed medication alongside routine counseling and dietary therapy. It is hard for someone without an eating disorder to understand why someone suffering from anorexia nervosa would go without food.
Most people In extreme cases, disordered eating habits can cause severe malnutrition, A dedicated fitness routine is a great way to stay healthy and fit, but as with everything else in life, people can take things too far. For some If you suspect your child has an eating disorder, you may feel overwhelmed.
There are a few things you should know upfront. Hypoglycemia is a medical term that refers to low blood sugar levels. Usually, this condition is considered a complication of type 1 diabetes.
Diuretics are a class of drugs that promote diuresis, a process that increases the production and output of urine.
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