Bulimia nervosa

Within a year of Russell s description, bulimia nervosa was included in version three of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM El). 

Although bulimia nervosa was originally described as a variant of anorexia nervosa, the two conditions are classified separately in DSM IV. The distinction between anorexia nervosa of the binge-eating/purging type and bulimia nervosa is based almost exclusively on the patient s body 

As with the other eating disorders, bulimia nervosa is some ten times more common in females than males. The prevalence of bulimia nervosa among young women in the United States is 1.1-4.2% (Kendler et al. 1991 Garfinkel et al. 1995). 

This sometimes takes the form of shoplifting of food items required to support bingeing 

Serotonin has been given a central role in the pathophysiology of bulimia nervosa (Kuikka et al. 2001). Challenge tests have revealed a blunted prolactin response to systemic administration of the 5-HT receptor agonists metachlorophenylpiperazine (mCPP) (Levitan et al. 1997) and dl-fenfluramine (Jimerson et al. 1997) in this condition. The higher the frequency of bingeing, the more blunted the prolactin response (Monteleone 

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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. 

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. 

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. 

Bupropion has also been used to treat the eating disorders anorexia nervosa and bulimia nervosa. Unfortunately, their electrolyte abnormalities leave patients with eating disorders especially vulnerable to seizures therefore, bupropion is no longer used to treat them. 

Characteristic Anorexia Nervosa Bulimia Nervosa Binge-Eating Disorder... 

E. No repeated attempts to compensate for overeating and does not fulfill criteria for bulimia nervosa or anorexia nervosa. 

Bellini M, Merli M. Current drug treatment of patients with bulimia nervosa and hingeeating disorder selective serotonin reuptake inhihitors versus mood stabilizers. Int J Psychiatry Clin Pract 2004 8 235-243. 

In addition to their proven efficacy in the treatment of all types of depression, the SSRIs have been shown to be the drugs of choice in the treatment of panic disorder, obsessive-compulsive disorder, bulimia nervosa, and as an adjunct to the treatment of alcohol withdrawal and relapse prevention, premenstrual dysphoric disorder and post-traumatic stress disorder. The usefulness of these drugs in treating such a diverse group of disorders reflects the primary role of serotonin in the regulation of sleep, mood, impulsivity and food intake. 

Unlabeled Uses Relief of neuropathic pain, such as that experienced by patients with diabetic neuropathy or postherpetic neuralgia treatment of anxiety, bulimia nervosa, migraine, nocturnal enuresis, panic disorder, peptic ulcer, phantom limb pain... 

Unlabeled Uses Treatment of bulimia nervosa, cataplexy associated with narcolepsy, depression, neurogenic pain, panic disorder, ejaculatory disorders, pervasive developmental disorder... 

AN, anorexia nervosa BN-AN, bulimia nervosa-anorexia nervosa, fMRI, functional magnetic resonance imaging PET, positron emission tomography rec, recovered SPECT, single photon emission computed tomography. 

Bulik, C.M., Sullivan, P.F., and Kendler, K.S. (1998) Heritability and reliability of binge-eating and bulimia nervosa. Biol Psychiatry 44 1210-1218. 

Burnet, P.W., Smith, K.A., Cowen, P.J., Fairburn, C.G., and Harrison, P.J. (1999) Allelic variation of the 5-HT2C receptor (HTR2C) in bulimia nervosa and binge eating disorder. Psychiatr Genet, 9 101-104. 

Fava, M., Copeland, P.M., Schweiger, U., and Herzog, D.B. (1989) Neurochemical abnormalities of anorexia nervosa and bulimia nervosa. Am Psychiatry 146 963-971. 

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