Pharmacotherapy of Bulimia Nervosa

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1. Antidepressant medications are useful in the treatment of bulimia nervosa, whether or not accompanied by major depression; symptoms of binging and purging are reduced.

2. Fluoxetine (Prozac) is effective at a dosage of 20-60 mg per day. Other SSRIs are also effective.

3. Imipramine (Tofranil) or desipramine (Norpramin) at a low dosage (50 mg per day), increasing by 50-mg increments every 3-4 days, to a daily dose of 150 mg. The serum drug level is measured after 1 week.

4. Bupropion is contraindicated because of the increased risk of seizures in these patients.

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