Psychiatric disorders bulimia

Lilenfeld, L.R., Kaye, W.H., Greeno, C.G., Merikangas, K.R., Plotnicov, K., Pollice, C., Rao, R., Strober, M., Bulik, C.M., and Nagy, L. (1998) A controlled family study of anorexia nervosa and bulimia nervosa psychiatric disorders in first-degree relatives and effects of proband comorbidity. Arch Gen Psychiatry 1998 55 603-610. 

Clinicians will readily recognize in Table 3.7 the experiences reported by many of their patients when receiving treatment for depression or other related psychiatric disorders. By looking at the Function affected column, it is possible to understand why some medications (say, SSRIs) are effective in variable degrees in several conditions associated with serotonin dysfunction (depression, OCD, social anxiety disorder, posttraumatic stress disorder, generalized anxiety disorder, panic disorder, and bulimia nervosa). 

Monoamine oxidase inhibitors are used to treat depression, atypical depression, bulimia, posttrau-matic stress reactions, obsessive-compulsive disorder, panic attacks, narcolepsy, phobias, hypochondria, anxiety, and many other psychiatric disorders as well as night tremors, parkinsonism, postural hypotension, headache, and aphthous stomatitis. 

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. 

Braun, D., Sunday, S., and Halmi, K.A. (1994) Psychiatric comorbidity in patients with eating disorders. Psychol Med 24 859—967. Brewerton, T.D., Lydiard, R.B., Herzog, D.B., and Brotman A.W. (1995) Comorbidty of axis I psychiatric diagnoses in bulimia nervosa. J Clin Psychiatry 56 77-80. 

The role of medication in the treatment of bulimia nervosa seems better established than its role in the treatment of anorexia nervosa. The American Psychiatric Association Practice Guideline for Eating Disorders ( 510) suggests that antidepressants may be useful in bulimia nervosa with or without depression. They may be particularly helpful, however, in those with depression, anxiety, obsessions, or who have failed psychosocial therapies. 

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