Which medications in the drug class Antidepressants, SSRIs are used in the treatment of Anorexia Nervosa?

Updated: Jun 10, 2019
  • Author: Bettina E Bernstein, DO; Chief Editor: Caroly Pataki, MD  more...
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Antidepressants, SSRIs

These agents have been reported to reduce binge eating, vomiting, and depression and to improve eating habits, although their impact on body dissatisfaction remains unclear.

Fluoxetine (Prozac)

Fluoxetine selectively inhibits presynaptic serotonin reuptake, with minimal or no effect on the reuptake of norepinephrine or dopamine. It may cause more adverse gastrointestinal effects than other currently available SSRIs, which is the reason it is not recommended as a first choice.

Fluoxetine can be administered as a liquid or a capsule and can be given in single or divided doses. The presence of food does not appreciably alter levels of the medication. It may take up to 4-6 weeks to achieve steady-state levels of the medication because it has a long half-life (72 h). The long half-life is both an advantage and a drawback. If fluoxetine works well, an occasional missed dose is not a problem; if fluoxetine-related problems occur, however, eliminating all active metabolites takes a long time.

The choice to use fluoxetine depends on adverse effects and drug interactions. Adverse effects of SSRIs seem to be quite idiosyncratic; thus, relatively few reasons exist to prefer one over another at this point if dosing is started at a conservative level and advanced as tolerated.

Fluoxetine is indicated for the treatment of binge eating and self-induced vomiting in patients with moderate to severe bulimia nervosa. The drug's antidepressant, anti–obsessive-compulsive, and antibulimic actions are presumed to be linked to inhibition of the central nervous system's uptake of serotonin.

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