fluvoxamine and Bulimia

Topics: Adult; Ambulatory Care; Anxiety Disorders; Bulimia; Depression; Drug Utilization Review; Fluvoxamine; Hospitalization; Humans; Mental Disorders; Outcome and Process Assessment, Health Care

Topics: Adolescent; Adult; Bulimia; Combined Modality Therapy; Double-Blind Method; Epilepsy, Tonic-Clonic; Female; Fluvoxamine; Follow-Up Studies; Humans; Long-Term Care; Middle Aged; Prospective Studies; Psychotherapy, Brief; Risk Assessment; Secondary Prevention; Selective Serotonin Reuptake Inhibitors

Twenty subjects with binge eating disorder were randomly assigned to flexible-dose fluvoxamine or placebo for 12 weeks. A significant reduction in binge frequency, Beck Depression Inventory scores and the eating concern, shape concern and weight concern subscales of the Eating Disorder Examination were noted for both fluvoxamine (n = 9) and placebo (n = 11) groups. There were no significant differences between fluvoxamine and placebo for any treatment outcome variables. The findings from this small trial contribute to the inconsistent results of antidepressant studies in binge eating disorder.

Topics: Adult; Body Mass Index; Bulimia; Double-Blind Method; Female; Fluvoxamine; Humans; Male; Selective Serotonin Reuptake Inhibitors; Severity of Illness Index

Many patients with seasonal affective disorder (SAD) have dysfunctional eating behaviors. Conversely, many women with bulimia nervosa have marked winter worsening of mood and bulimic symptoms. Controlled studies of light therapy in SAD and in bulimia nervosa have shown beneficial effects on mood and binge/purge symptoms. We explored the clinical use of light therapy in women with SAD who also had comorbid bulimia nervosa.. Twenty-two female patients diagnosed using DSM-IV criteria with both bulimia nervosa and major depressive disorder with a seasonal (winter) pattern were treated with an open design, 4-week trial of light therapy (10,000 lux fluorescent light box with an ultraviolet filter, 30 to 60 minutes per day in the early morning). Patients were assessed before and after treatment with depression scales and with binge/purge diaries.. Light therapy resulted in significant improvement in mood, with a mean 56% reduction in 29-item Hamilton Rating Scale for Depression scores following treatment (p < .001). The frequency of binges and purges per week also significantly decreased (p < .001) from baseline by a mean of 46% and 36%, respectively. Two (9%) of 22 patients became abstinent of binge/ purge episodes, compared with 10 (45%) of 22 patients who met criteria for remission of depressive symptoms. The light therapy was well tolerated by patients.. These results suggest that therapeutic effects of light therapy on mood and bulimic symptoms in patients with SAD and comorbid bulimia nervosa are sustained over at least 4 weeks. However, the low abstinence rate in bulimic symptoms indicates that light therapy may be most effectively used as an adjunctive treatment to medications and/or psychotherapy for bulimia nervosa.

Topics: Adolescent; Adult; Bulimia; Comorbidity; Female; Fluoxetine; Fluvoxamine; Humans; Multi-Institutional Systems; Personality Inventory; Phototherapy; Placebos; Psychiatric Status Rating Scales; Retrospective Studies; Seasonal Affective Disorder; Severity of Illness Index; Treatment Outcome

The purpose of this study was to assess the efficacy of fluvoxamine in the treatment of binge-eating disorder. Binge-eating disorder is a newly described eating disorder characterized by recurrent episodes of binge eating but without purging behaviors. Uncontrolled reports have suggested that serotonin selective reuptake inhibitors (SSRIs) may be effective in treating this disorder.. Eighty-five outpatients with a DSM-IV diagnosis of binge-eating disorder were randomly assigned to receive either fluvoxamine (N=42) or placebo (N=43) in a 9-week, parallel-group, double-blind, flexible dose (50-300 mg) study at three centers. The primary outcome measures were frequency of binge eating, expressed as log ([binges/week]+1), and Clinical Global Impression (CGI) scale ratings. Secondary measures included the level of response (based on the percentage change in frequency of binges), body mass index, and Hamilton Rating Scale for Depression score. Except for the level of response, the outcome measures were analyzed by random regression methods; the treatment-by-time interaction was the measure of treatment effect.. Compared with placebo, fluvoxamine was associated with a significantly greater rate of reduction in the frequency of binges, rate of reduction in CGI severity scores, rate of increase in CGI improvement scores, level of response for patients who completed the 9-week study, and rate of reduction in body mass index. There was no significant difference between placebo and fluvoxamine groups in the rate of decrease in Hamilton depression scale scores. A significantly greater proportion of patients receiving fluvoxamine than those receiving placebo discontinued treatment because of an adverse medical event.. In this placebo-controlled trial, fluvoxamine was found to be effective according to most outcome measures in the acute treatment of binge-eating disorder.

Topics: Adolescent; Adult; Bulimia; Double-Blind Method; Female; Fluvoxamine; Humans; Male; Middle Aged; Placebos; Treatment Outcome

The efficacy of fluvoxamine in maintaining improvement of general psychopathology (depression, obsessive-compulsive symptoms, anxieties, interpersonal trust, and body perception) was tested in a double-blind placebo-controlled study of 72 patients with bulimia nervosa who were being treated successfully with inpatient behavioral psychotherapy. Over a period of about 15 weeks (2-3 weeks inpatient titration phase, 12 weeks outpatient relapse-prevention phase), fluvoxamine or placebo were given. The relapse-prevention design was used to avoid potential confounding effects of other concomitant treatments. Assessments concerning general psychopathology were made on the basis of expert ratings (CGI, HDRS) and self ratings (HSCL, Eating Disorders Inventory (EDI)-subscales "ineffectiveness," "perfectionism," "maturity fears," "interpersonal distrust," and "interoceptive awareness"). Fluvoxamine had significant effects in preventing relapse as measured on the basis of the Clinical Global Impression (CGI) scale "severity of illness", and a positive trend for relapse preventing effects was observed for the HSCL "general symptomatic index". Further, a relapse preventing effect was observed for the HSCL subscale "obsessive-compulsive symptoms", but not for the EDI subscale "perfectionism". Various dependent variables measuring depression showed no significant relapse-preventing effects of fluvoxamine, but only positive trends. Fluvoxamine had no relapse preventing effects according to our results for dependent variables assessing anxieties, interpersonal trust, and body perception. During a final short (4-week) off-medication phase, no statistically significant effects of discontinuation of medication, but some trends in the expected directions, were observed.

Topics: Adult; Antidepressive Agents, Second-Generation; Anxiety; Bulimia; Depression; Female; Fluvoxamine; Humans; Psychiatric Status Rating Scales; Recurrence

In a double-blind, placebo-controlled study of 72 patients with bulimia nervosa treated successfully with inpatient psychotherapy, the efficacy of fluvoxamine in maintaining improvement was tested. Fluvoxamine and placebo, respectively, were given over a period of about 15 weeks (2-3 weeks inpatient titration phase, 12 weeks outpatient relapse-prevention [maintenance] phase). The variables assessed concerned bulimic behavior and other aspects of eating disorders, global status, depression, anxieties, obsessive-compulsive behavior, and other aspects of psychopathology. Because the dropout rate was relatively high (N = 27 [33%]) and because it was considerably higher in the fluvoxamine group (19 out of 37 subjects), analyses were performed on the intent-to-treat sample (ideally including all 72 subjects). Results of the completer sample analyses (including only those subjects who finished the study) are briefly presented for comparison. In both the intent-to-treat and the completer analyses, the following scales showed fluvoxamine to have a significant effect in reducing the return of bulimic behavior: (1) self-ratings: Eating Disorder Inventory (EDI)-bulimia, urges to binge in previous week and the number of actual binges in the previous week; (2) expert ratings: Psychiatric Status Rating Scales for Bulimia nervosa, Structured Interview for Anorexia and Bulimia nervosa (SIAB)-"total score," SIAB-subscale "fasting," and SIAB-subscale "vomiting." Two further variables (EDI-total score and SIAB-subscale "bulimia") showed the superior relapse prevention effects of fluvoxamine compared with placebo for the completer sample, while they did not reach significance for group-by-time interactions in the intent-to-treat sample. During a final, short (4-week) off-medication phase, no effect of the discontinuation of medication was observed.

Topics: Adolescent; Adult; Antidepressive Agents, Second-Generation; Body Image; Bulimia; Double-Blind Method; Feeding Behavior; Fluvoxamine; Humans; Middle Aged; Patient Dropouts; Psychiatric Status Rating Scales; Recurrence; Self-Assessment

Fifteen women with bulimia nervosa were treated with a 4-month course of combined cognitive-behavioral, nutritional and antidepressant therapy (5 with amineptine and 10 with fluvoxamine). Patients were monitored before and after 1, 2 and 4 months of therapy for body mass index (BMI), for eating disorder symptoms by the Eating Disorder Inventory (EDI) and the Bulimic Investigation Test (BITE), and for depression and anxiety by the Hamilton Rating Scale for Depression and for Anxiety (HRS-D and -A). BITE symptoms and gravity improved significantly and equally in the two groups during the 4 months of therapy. Global EDI scores, depression and anxiety decreased but not significantly. BMI was normal before therapy and did not change during treatment.

Topics: Adolescent; Adult; Antidepressive Agents, Second-Generation; Antidepressive Agents, Tricyclic; Behavior Therapy; Body Weight; Bulimia; Cognitive Behavioral Therapy; Combined Modality Therapy; Dibenzocycloheptenes; Female; Fluvoxamine; Humans; Nutritional Physiological Phenomena; Psychiatric Status Rating Scales; Recurrence; Time Factors

Compulsive buying behaviour has recently received long overdue attention as a clinical issue. Aim of this report is to describe treatment of two female patients diagnosed with compulsive buying disorder in comorbidity with binge eating disorder. In both cases, criteria for diagnosing of other axis I or axis II disorder were not present. Fluvoxamine was used in pharmacotherapy, and psychodynamic psychotherapy as a psychotherapeutical approach. We conclude that fluvoxamine and psychodynamic psychotherapy may be effective in treatment of compulsive buyers in comorbidity with binge eating disorder.

Topics: Adult; Anti-Anxiety Agents; Bulimia; Compulsive Behavior; Female; Fluvoxamine; Guilt; Humans; Psychotherapy

Previous reports indicate that elevated serum levels of androgens in women may contribute to the development of bulimia nervosa and other conditions characterized by impaired impulse control and/or depressed mood. This report describes the effect of treatment with the testosterone antagonist flutamide (250-500 mg daily) in two women with severe bulimia. Both subjects reported a marked improvement with respect to bulimic behaviour within a week after initiation of flutamide treatment; when the drug was withdrawn, both patients relapsed. It is concluded that further investigations of the possible efficacy of androgen antagonism in eating disorders are warranted.

Topics: Adult; Androgen Antagonists; Bulimia; Female; Flutamide; Fluvoxamine; Humans; Selective Serotonin Reuptake Inhibitors; Testosterone

Topics: Adult; Bulimia; Clozapine; Dose-Response Relationship, Drug; Drug Monitoring; Drug Therapy, Combination; Female; Fluvoxamine; Humans; Obsessive-Compulsive Disorder; Schizophrenia

Concentrations of cholecystokinin-8 (CCK-8) and beta-endorphin (beta-EP) in T-lymphocytes of 26 women with bulimia nervosa (BN) and in 26 age- and sex-matched healthy comparison subjects were measured. Ten patients were then treated with 300 mg/day of fluvoxamine, p.o., and five patients were treated with 300 mg/day of amineptine, p.o., for 4 months. Concentrations of the two peptides were measured again after 1, 2, and 4 months of therapy. Basal CCK-8 values were significantly lower in patients than in healthy subjects. During fluvoxamine therapy, CCK-8 values increased, reaching normal levels by month 4 of treatment. No such increase occurred during amineptine therapy. Baseline beta-EP values were normal in the bulimic patients but had declined by month 4 of fluvoxamine therapy.

Topics: Adolescent; Adult; Antidepressive Agents, Tricyclic; beta-Endorphin; Bulimia; Cognitive Behavioral Therapy; Combined Modality Therapy; Dibenzocycloheptenes; Female; Fluvoxamine; Humans; Middle Aged; Selective Serotonin Reuptake Inhibitors; Sincalide; T-Lymphocytes; Treatment Outcome

Twenty patients suffering from bulimia nervosa received 50-150 mg fluvoxamine daily for a period of 8 weeks. Primary end-points included the Eating Disorders Inventory (EDI), the Severity Index of Bulimic Condition (BINGE), Clinical Global Impression (CGI) scores, and the number of binge eating episodes per week. Other variables assessed included the 17-item Hamilton Depression Scale and adverse experience checklist. Compared with baseline, total EDI scores increased significantly from 137.8 to 155.3 after 8 weeks of fluvoxamine treatment (p < .001); CGI score fell significantly from 3.5 to 2.3 (p < .01) during this period. The mean number of binge eating episodes recorded by patients significantly decreased (p < .001). Further significant improvements in bulimic behavior were noted using the BINGE questionnaire. Nine of 20 patients complained of adverse experiences, all of which were mild; the most common symptoms were somnolence (n = 4) and insomnia (n = 3). Fluvoxamine appears to be a safe and effective treatment for bulimia nervosa.

Topics: Adult; Bulimia; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Fluvoxamine; Humans; Male; Personality Inventory; Treatment Outcome

The results of a small pilot study using Fluvoxamine (Faverin) in the treatment of non-vomiting bingeing female patients and women with bulimia nervosa is presented. Ten non-vomiting subjects and six with bulimia nervosa were treated on an open basis with Fluvoxamine 100-200 mg daily. Assessment was made using established questionnaires for severity of eating disorder and abnormality of mood. Five non-vomiting patients and three with bulimia nervosa completed the study. Non-vomiters showed a significant weight loss; a significant reduction in number of binges; a significant reduction in the scores on the BITE and the EAT; and a significant reduction in anxiety. Those with bulimia nervosa had a significant reduction in hunger and a reduction in depression which tended towards significance. Firm conclusions cannot be drawn from this study as it is an open pilot study of a small number of women. However, the results indicate that Fluvoxamine may have a role in the treatment of eating disorders where bingeing is a prominent symptom and that further research would be valuable. Comments are also made on the usefulness of various questionnaires designed to assess eating disorders.

Topics: Adolescent; Adult; Bulimia; Depression; Feeding and Eating Disorders; Female; Fluvoxamine; Humans; Obesity; Surveys and Questionnaires; Vomiting; Weight Loss

Three cases of blood-letting in association with bulimia nervosa are reported. This association has not previously been described.

Topics: Adult; Bloodletting; Bulimia; Child of Impaired Parents; Combined Modality Therapy; Depressive Disorder; Fluoxetine; Fluvoxamine; Humans; Personality Development; Phenelzine; Phototherapy; Psychotherapy; Psychotherapy, Group; Students, Medical

Topics: Adult; Bulimia; Female; Fluvoxamine; Humans; Psychiatric Status Rating Scales