Antidepressant treatment of bulimia: the relationship between bingeing and depressive symptomatology

In a retrospective study, 22 patients with bulimia were treated with at least one therapeutic trial of antidepressants. Most patients (77%) were clinically depressed before the drug trial. Bingeing frequency decreased in 59% of all cases, and depression improved in 58% of depressed subjects after a 4-week trial of antidepressants, although only 27% of all patients showed both an antibinge and an antidepressant response. Furthermore, during a 3-month follow-up period, several patients relapsed despite continuing medication. At the end of the follow-up period, 23% of subjects continued to show at least a 50% decrease in their bingeing. These data indicate that medication may have separate and possibly unrelated antibinge and antidepressant effects in this patient population.