Bulimia

Bulimia and anorexia nervosa Cyclic vomiting syndrome... 

Bupropion causes insomnia, nightmares, decreased appetite, anxiety, and tremors, but the most concerning adverse effect is seizures. Because of the risk for seizures, patients who should not receive the drug include those with a CNS lesion or those with a history of seizures, head trauma, or bulimia. The daily dose of bupropion should not exceed 450 mg/day, and any single dose of the immediate-release formulation should not exceed 150 mg/day Occurrences of insomnia and/or nightmares often respond to moving the last daily dose from bedtime to late afternoon.7,9,22,23... 

Kasper S, Tauscher J, Willeit M, Stamenkovic M, Neumeister A, Kufferle B, Barnas C, Stastny J, Praschak-Rieder N, Pezawas L et al. (2002). Receptor and transport imaging studies in schizophrenia, depression, bulimia and Tourette s disorder Implications for psychopharmacology. World Journal of Biological Psychiatry, 3, 133-146. 

This book has examined how diet pills work and which herbal and prescription products are most commonly used for weight loss. Disorders such as anorexia, bulimia, and body dysmorphic syndrome may lead someone to abuse both over-the-counter and prescription diet pills. There are health and legal ramifications of diet pill abuse that are ignored or not even realized when abuse is taking place. 

The signs and symptoms of bulimia are similar to those of anorexia. Other signs may include binge eating and inappopri-ate use of diuretics or laxatives. Cavities or gum infections may develop, or the enamel of the teeth may show signs of being stripped off, because of the frequent exposure to stomach acid. 

Neuropeptides play key roles in appetite regulation and obesity. Many genes for neuropeptides and neuropeptide receptors have been implicated in obesity and cachexia, anorexia and bulimia [34]. For example,NPY administration into the CNS causes overeating and obesity. A second peptide involved in obesity is leptin, a product of adipocytes and the stomach. The leptin gene is defective in the ob/ob mouse but in normal mice leptin binds to its receptor in the hypothalamus, causing a decrease in the synthesis and release of hypothalamic NPY. 

The occurrence of seizures with bupropion is dose related and may be increased by predisposing factors (e.g., history of head trauma or CNS tumor). At the ceiling dose (450 mg/day), the incidence of seizures is 0.4%. Other side effects include nausea, vomiting, tremor, insomnia, dry mouth, and skin reactions. It is contraindicated in patients with bulimia or anorexia nervosa. 

Bupropion sustained release (SR) is an effective smoking-cessation treatment. It is contraindicated in patients with a seizure disorder, a current or prior diagnosis of bulimia or anorexia nervosa, and use of a monoamine oxidase inhibitor within the previous 14 days. It can be used in combination with NRT. 

The DSM-IV includes two primary eating disorder diagnoses Anorexia Nervosa (AN) and Bulimia Nervosa (BN). The DSM also includes a... 

Gleaves, D., Lowe, M., Green, B., Cororve, M., Williams, T. (in press). Do anorexia and bulimia nervosa occur on a continuum A taxometric analysis. Behavior Therapy. 

Millions of people in the United States are affected by eating disorders. More than 90% of those afflicted are adolescents or young adult women. Although all eating disorders share some common manifestations, anorexia nervosa, bulimia nervosa, and binge eating each have distinctive symptoms and risks. 

According to the passage, which of the following is true of bulimia patients ... 

Nacmias, B., Ricca, V., Tedde, A., Mezzani, B., RoteUa, C. M., and Soibi, S. (1999) 5-HT2A receptor gene polymorphisms in anorexia nervosa and bulimia nervosa. Neurosci. Lett. 277, 134-136. 

See the second and third paragraphs for reference to heart problems with anorexia, the fourth and fifth paragraphs for discussion of heart problems with bulimia, and the last paragraph, where heart disease is mentioned, as a risk in obese people who suffer from bingeeating disorder. 

It is the other way around 50% of people with anorexia develop bulimia, as stated near the end of the fifth paragraph. 

The first sentence of the fifth paragraph tells us that bulimia sufferers are often able to keep their problem a secret, partly because they maintain a normal or above-normal weight. 

As stated in the opening sentence of the fourth paragraph, bulimia patients may exercise obsessively. 

Fluoxetine (Prozac). The first SSRI introduced in the United States, fluoxetine was for many years the most prescribed antidepressant in the world. It is approved for the treatment of MDD, OCD, and bulimia nervosa. Fluoxetine can be started at 10 or 20 mg in a single dose taken with a meal. Many patients experience a complete recovery at the 20mg/day dose, but fluoxetine can be increased up to 80mg/day. The treatment of bulimia nervosa and OCD usually requires these higher doses. 

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