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Prozac Doesn't Stop Anorexia Relapse

Study Shows the Antidepressant Doesn't Help Anorexics Who Had Recently Gained Weight
WebMD Health News
Reviewed by Louise Chang, MD

June 13, 2006 -- The antidepressant drug Prozac does not help prevent relapses in patients recovering from anorexia anorexia nervosa, new research shows.

Researchers from Columbia University and University of Toronto compared treatment with Prozac (fluoxetine) to that with placebo in patients who had recently regained weight after intensive hospital-based treatment. They found no significant difference in relapse rates between the two groups.

Fewer than half of the patients -- 43% of those taking Prozac and 45% of those taking placebo -- maintained their weight gains for a year.

The large, rigorously designed trial is the latest of many studies to show no benefit for drug therapy in the treatment of anorexia nervosa, a serious psychiatric illness that mainly affects women and adolescent girls.

"A lot of medications have been studied, but the findings have been pretty disappointing," says University of Minnesota psychiatry professor Scott J. Crow, MD. "We haven't got a good drug option for anorexia right now."

The findings are reported in The Journal of the American Medical Association.

Death Rate Is High

The search for better treatments is critical, Crow tells WebMD, because anorexia nervosa is a deadly disease with a mortality rate as high as 10% to 15%.

"Actually, the only psychiatric illness that may have a higher mortality rate is opiate dependence," he says. "And anorexia nervosa has the highest suicide rate of any psychiatric disorder."

Although treatments aimed at helping patients regain a healthy weight are often successful, relapses are common.

B. Timothy Walsh, MD, who led the latest study, tells WebMD that roughly 50% of patients relapse within a year.

Antidepressants are often prescribed to patients with the eating disorder, even though studies have consistently shown that drugs have little impact on outcomes during the initial phase of treatment, when patients are still underweight.

Walsh and colleagues conducted the newly published study to determine if antidepressants help prevent relapses after weight has been restored.

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.

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