Prozac Doesn't Stop Anorexia Relapse
Study Shows the Antidepressant Doesn't Help Anorexics Who Had Recently Gained Weight
More to Anorexia Than Depression
The trial included 93 female anorexia nervosa patients (average age was early 20s) who gained weight as inpatients or day patients at the New York State Psychiatric Institute or Toronto General Hospital.
Once the weight-gain phase of treatment ended, all the patients continued to get psychiatric counseling in the form of cognitive behavioral therapy and monitoring by a psychiatrist. Forty-nine were randomly assigned to treatment with Prozac and 44 were treated with placebo for up to a year. Neither the patient nor her psychiatrist knew which drug treatment they were getting.
The relapse rate was high in both groups, and there was no significant difference between the two treatment groups in the time to relapse.
Depression and other psychiatric illnesses that are helped with antidepressants are common among people with anorexia nervosa. But the findings show that there is more going on with the disorder, Walsh says.
Walsh is a professor of psychiatry at New York State Psychiatric Institute/Columbia University Medical Center.
"This isn't simply depression or anxiety," he says. "If it were, we would expect medication to be more effective."
Psychiatric treatments like cognitive behavioral therapy are widely believed to have some benefit in the treatment of anorexia nervosa. And a new type of family therapy in which eating is closely monitored by a parent is showing promise for the treatment of children and young adolescents with the eating disorder.
Walsh and Crow agree that much more research is needed to identify the best treatment strategies for helping patients with anorexia nervosa gain weight and avoid relapse.
Crow says the stigma that accompanies eating disorders may have had a chilling impact on this research in the past.
"There has been a little bit of a feeling that all an anorexic needs to do to get better is start eating, but it is nowhere near that simple," he says. "Nobody would say [to a psychotic] that they should just stop hallucinating."