Response to alternative antidepressants in imipramine nonresponders with bulimia nervosa

The authors report the results of open-label antidepressant trials in a series of normal weight bulimic women who showed an inadequate response to an initial trial of imipramine hydrochloride as part of a treatment comparison study. The results indicate that a significant percentage of subjects responded to a second trial of an alternative agent. Overall, 47% had a complete remission of symptoms during the second trial, usually with a monoamine oxidase inhibitor or fluoxetine. The authors stress the importance of persisting in trials of alternative agents if bulimic patients fail to respond to an initial trial.