Antidepressant medicines can help reduce binge eating
and purging in people who have
Antidepressants work best when combined with
counseling for the treatment of bulimia.2
Antidepressants that are most commonly used to reduce the binge-purge cycle
associated with bulimia are:
Fluoxetine (such as Prozac), which is a selective serotonin
reuptake inhibitor (SSRI). Fluoxetine reduces
binge-purge cycles in bulimia.3 Other SSRIs have not yet been proven to be effective
Tricyclics, such as imipramine (Tofranil, for
example), amitriptyline, and desipramine (Norpramin, for example).
Antidepressants regulate brain chemicals that control mood.
Guilt, anxiety, and depression about binging usually lead to purging.
Antidepressants help keep emotions stable and can help reduce the frequency of
It may take several weeks for
antidepressants to relieve symptoms associated with binge eating disorder,
although they may become effective sooner. You may need to continue taking
antidepressants over a long period of time to prevent a
Antidepressants that may be used to treat binge eating disorder
Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine
(Prozac, for example) or fluvoxamine (Luvox).
Tricyclics, such as
imipramine (Tofranil) or desipramine (Norpramin).
antidepressants such as trazodone.
Antidepressants regulate brain chemicals that control mood and feelings of fullness.
They can help regulate the body's hunger signals that leads to binge eating. These drugs
can also help people who have both depression and binge eating disorder.
Antidepressant side effects
produce some side effects. But side effects may be reduced or may go away after
several weeks of treatment.
Before starting an antidepressant,
tell your doctor about every medicine or supplement (prescription or
nonprescription) that you are taking. Some antidepressants can have serious
interactions with other medicines or dietary supplements.
Selective serotonin reuptake inhibitors (SSRIs)
that SSRIs may be less bothersome than other antidepressants, such as
tricyclics. SSRIs have less serious side effects and are less dangerous in case
of an overdose. Although side effects of SSRIs are usually mild, they can
include nausea, loss of appetite, diarrhea, anxiety, irritability, problems
sleeping or drowsiness, loss of sexual desire or ability, headaches, dizziness,
and dry mouth. After several weeks of treatment, SSRI side effects may be less
or may go away completely.
Tricyclic side effects can
include stomach upset, constipation, dry mouth, blurred vision, and drowsiness.
Some people gain weight and have problems with sexual desire and ability.
Tricyclics are started in low doses and gradually increased to avoid overdose
and other serious side effects.
Be sure to tell your doctor about
all the medicines and herbal preparations you are currently taking. Tricyclic
antidepressants can have serious interactions with other medicines, including
those used to treat seizures, such as phenytoin (Dilantin, for example), or
certain heart medicines, such as digoxin (for example, Lanoxin).
has different side effects than tricyclic antidepressants. It has side
effects similar to those of SSRIs and may have additional side effects.
Possible side effects of trazodone include drowsiness,
dizziness or lightheadedness, blurred vision, weight gain, dry mouth,
constipation, headache, and nausea.
What to think about
You may start to feel better
within 1 to 3 weeks of taking antidepressant medicine. But it can take as many
as 6 to 8 weeks to see more improvement. If you have questions or concerns
about your medicines, or if you do not notice any improvement by 3 weeks, talk
to your doctor.
Studies have found daily use of SSRIs may
increase the risk of bone fracture in adults over age 50. Talk to your doctor
about this risk before taking an SSRI.
bleeding more likely in the upper gastrointestinal tract (stomach and
esophagus). Taking SSRIs with NSAIDs (such as Aleve or Advil) makes bleeding
even more likely. Taking medicines that control acid in the stomach may
People who purge after
they take antidepressants may not get enough of the medicine into their blood.
Doctors may recommend that they take antidepressant medicine at
bedtime after they have stopped purging. People who purge often need to have
their blood checked regularly to measure the amount of medicine in their
Steering Committee on Practice Guidelines, American Psychiatric Association (2006). Treating Eating Disorders: A Quick Reference Guide. Arlington, VA: American Psychiatric Publishing.
Yager J, et al. (August 2012). Guideline Watch: Practice Guideline for the Treatment of Patients With Eating Disorders, 3rd ed.
Arlington, VA: American Psychiatric Association. Also available online: http://psychiatryonline.org/content.aspx?bookid=28§ionid=39113853.
Hay PJ (2010). Bulimia nervosa, search date January 2010. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Sigel EJ (2012). Eating disorders. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 21st ed., pp. 167–178. New York: McGraw-Hill.
McElroy SL, et al. (2012). Current pharmacotherapy options for bulimia nervosa and binge eating disorder.
Expert Opinion on Pharmacotherapy, 13(14): 2015–2026.
Abajo FJ, Garcia-Rodriguez LA (2008). Risk of upper
gastrointestinal tract bleeding associated with selective serotonin reuptake
inhibitors and venlafaxine therapy. Archives of General Psychiatry, 65(7): 795–803.
ByHealthwise Staff Primary Medical ReviewerKathleen Romito, MD - Family Medicine Specialist Medical ReviewerW. Stewart Agras, MD, FRCPC - Psychiatry
Current as ofNovember 14, 2014
WebMD Medical Reference from Healthwise
November 14, 2014
This information is not intended to replace the advice of a doctor.
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