Advances in Therapy

, Volume 21, Issue 4, pp 232–237 | Cite as

Treatment of bulimia nervosa with sertraline: A randomized controlled trial

  • W. Milano
  • C. Petrella
  • C. Sabatino
  • A. Capasso
Article

Abstract

Bulimia nervosa (BN) is one of the most frequently encountered eating disorders in industrialized societies. It has been suggested that reduced serotonin activity may trigger some of the cognitive and mood disturbances associated with BN. Thus, pharmacologic treatment of BN is mainly based on the use of selective serotonin reuptake inhibitors, which have proved effective. At present, the biological basis of this disorder is not completely clear. The aim of this randomized, controlled trial was to verify the efficacy of sertraline, a selective serotonin reuptake inhibitor, in a group of patients with a diagnosis of BN. Twenty female outpatients, with an age range of 24 to 36 years and a diagnosis of purging type BN as defined by theDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV), were assigned randomly to two treatment groups. The first group received sertraline 100 mg/day for 12 weeks; the second group received placebo. The study was conducted for 12 weeks, with weekly clinical assessments. At the end of the observation period, the group treated with sertraline had a statistically significant reduction in the number of binge eating crises and purging compared with the group who received placebo. In no case was treatment interrupted because of side effects. This study confirms that sertraline is well tolerated and effective in reducing binge-eating crises and purging in patients with BN.

Keywords

bulimia serotonin SSRI 

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References

  1. 1.
    Muscettola G, Casiello M. Psicofarmacologia dei disordini del comportamento alimentare. In:Bellantuono, Balestrino Gli Psicofarmaci: Farmacologia e Terapia. Pensiero Scientifico Editore; 1997;62:13–24.Google Scholar
  2. 2.
    American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Washington, DC: American Psychiatric Association; 1994.Google Scholar
  3. 3.
    Walsh T, Devlin M: Eating disorders: progress and problems.Science. May 29, 1998;280: 1387–1390.PubMedCrossRefGoogle Scholar
  4. 4.
    Magnani M, Aveni E, Cuzzolaro M. Obesità e disturbi del comportamento alimentare. In: Borsello O.Obesità:un Trattato Multidimensionale. Editrice Kurtis; 1999;13:49–71.Google Scholar
  5. 5.
    Bellodi L, Brambilla F. Eating disorders and obsessive compulsive disorders: a pathogenetic link? Centro Scientifico Editore. 1999;22:56–60.Google Scholar
  6. 6.
    Brewerton TD. Toward a unifed theory of serotonin dysregulation in eating and related disorders.Psychoneuroendocrinology. 1995;20:561–590.PubMedCrossRefGoogle Scholar
  7. 7.
    Ramacciotti C. Terapia farmacologica della Bulimia Nervosa e del Binge Eating Disorder. In: Cuzzolaro M.Terapia Farmacologica dei Disturbi del Comportamento Alimentare. Editrice Kurtis; 2000;13:98–108.Google Scholar
  8. 8.
    Leibowitz SF, Sher-Posner G. Brain serotonin and eating behavior.Appetite. 1986;7(suppl 1):1–4.PubMedGoogle Scholar
  9. 9.
    Jimerson DC, Wolfe BE, Metzger ED, Finkelstein DM, Cooper TB, Levine JM. Decreased serotonin function in bulimia nervosa.Arch Gen Psychiatry. 1997;54:529–534.PubMedGoogle Scholar
  10. 10.
    Muller E, Brambilla F.Disordini del Comportamento Alimentare. Pythagora Press. 1997.Google Scholar
  11. 11.
    Devane CL. Comparative safety and tolerability of SSRI.Hum Psychopharmacol. 1995;10: 185–193.CrossRefGoogle Scholar
  12. 12.
    Henderson M, Freeman CP. A self-rating scale for bulimia. The “BITE.”Br J Psychiatry. 1987; 150:18–24.PubMedCrossRefGoogle Scholar
  13. 13.
    American Psychiatric Association: Practice guideline for the treatment of patients with eating disorder.Am J Psychiatry. 2000;157(gen suppl):1.Google Scholar
  14. 14.
    Kay WH. Serotonin regulation in bulimia. In: Hudson J, Pope HG, eds.The Psychobiology of Bulimia. Washington, DC: American Psychiatric Press; 1987.Google Scholar
  15. 15.
    Heym J, Koe BK. Pharmacology of sertraline: a review.Clin Psychiatry. 1998;49(suppl):40.Google Scholar
  16. 16.
    Koe BK. Preclinical pharmacology of sertraline: a potent and specific inhibitor of serotonin reuptake.J Pharmacol Exp Ther. 1990;51(suppl B):13.Google Scholar
  17. 17.
    Warrington SJ. Clinical implications of the pharmacology of sertraline.Int Clin Psychopharmacol. 1991;6(suppl 2):11.PubMedCrossRefGoogle Scholar
  18. 18.
    Ronfeld RA, Wilner KD, Baris BA. Sertraline: chronopharmacokinetics and the effect of coadministration with food.Clin Pharmacokinet. 1997;32(suppl 1):50.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science and Business Media and LLC 2004

Authors and Affiliations

  • W. Milano
    • 1
  • C. Petrella
    • 1
  • C. Sabatino
    • 2
  • A. Capasso
    • 2
  1. 1.Mental Health Operations UnitNaplesItaly
  2. 2.Department of Pharmaceutical SciencesUniversity of SalernoFisciano (Salerno)Italy

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