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Anti-Nausea Drug Helps Bulimics

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Cheryl says that is exactly how it feels to her. Previous psychotherapy had helped her overcome her distorted body image, but the compulsion to binge and purge remained. "It's not something that originated in my head; it was something visceral -- like a primal need," she says. "It had nothing to do with taste or what I wanted to eat."

Theorizing that Zofran would act to calm the overexcited nerves, Faris and co-workers used the drug to treat a few bulimic patients. It seemed to help, so they went on to conduct the study with severely bulimic women, who did not receive any other form of treatment during the six-week study period. On average, participants who received Zofran reduced the number of binge/purge episodes from more than 13 episodes per week to 6.5 episodes. No such reduction was seen in participants who got pills that did not contain the drug.

Would this kind of reduction mean anything to a patient? Cheryl says it would. "The time spent in the cycle consumes your life," she says. "To go from 14 to seven episodes saves people a lot of time; it gives them back their life. I went from seven to none. But even if I had gone from 10 to two, I would have been happy enough to save 30 hours of my life a week."

The speed of the reduction in binge/purge episodes with Zofran is remarkable, but Bruce A. Arnow, PhD, who was not connected with the study, tells WebMD that psychotherapy can reduce bulimic behavior even more. "Cognitive-behavioral therapy has substantially higher reductions in purging episodes, 70-90%," says Arnow, chief of Stanford University's behavioral psychiatry section. "Abstinence rates -- people who flat-out stop -- are between 30% and 50%. These benefits appear to be reasonably well maintained and are also associated with reduced [accompanying] symptoms such as depression."

Faris agrees that psychotherapy is an integral component of treatment for bulimia. In the expanded clinical trial for which she is now recruiting patients, only half the participants will receive Zofran, but all will receive psychotherapy. She suggests that the physicians of patients who are not responding to other treatments might want to try a short-term trial of the drug.

The main side effect of Zofran is constipation, which Cheryl describes as "terrible." But she carries the drug with her in case the craving to binge and purge comes back, as it did recently after three years of remission. "You live your life in a haze when you have this craving," she says. "With the drug, it is like seeing clearly again."

 

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