Bulimia is an eating disorder in which individuals consume large amounts of food in short periods of time accompanied by an awareness that the eating pattern is abnormal. The episodes of binge eating may occur several times a day and are commonly terminated by self-induced vomiting. Epidemiological surveys suggest that the prevalence of bulimia is 1 - 5% in young adult women. A number of observers have noted an association between mood disturbance and bulimia, and, in the last 5 years, several controlled studies have suggested that antidepressant medication is more effective than placebo in the short-term treatment of bulimia.
The aims of the proposed study are (1) to replicate the short-term therapeutic advantage of imipramine (IMI) over placebo in bulimia and (2) to determine the long-term (1 year) efficacy of IMI treatment. Over 3 years, 100 women of normal weight with chronic and moderately severe hulimia will be randomly assigned to receive 6 weeks of IMI or an active placebo, methscopolamine. Responders will be maintained for 4 additional months on continued IMI and will then be randomly assigned either to continue IMI or to switch to methscopolamine. Psychiatric diagnoses will be obtained via semi-structured interview (including the SADS and a newly developed assessment of personality) and patient outcome will be assessed using established rating instruments. This study will determine (1) if IMI is superior to an active placebo in the short term treatment of bulimia, (2) if successful initial outcome is sustained during 6 months of continued IMI treatment and (3) if discontinuation of IMI after 6 months of successful treatment leads to a high rate of relapse.
| Pauporte, J; Walsh, B T (2001) Serum cholesterol in bulimia nervosa. Int J Eat Disord 30:294-8 |
| Goldfein, J A; Walsh, B T; Midlarsky, E (2000) Influence of shape and weight on self-evaluation in bulimia nervosa. Int J Eat Disord 27:435-45 |
| Mayer, L E; Walsh, B T (1998) The use of selective serotonin reuptake inhibitors in eating disorders. J Clin Psychiatry 59 Suppl 15:28-34 |
| Walsh, B T; Wilson, G T; Loeb, K L et al. (1997) Medication and psychotherapy in the treatment of bulimia nervosa. Am J Psychiatry 154:523-31 |
| Loeb, K L; Pike, K M; Walsh, B T et al. (1994) Assessment of diagnostic features of bulimia nervosa: interview versus self-report format. Int J Eat Disord 16:75-81 |
| Brody, M L; Walsh, B T; Devlin, M J (1994) Binge eating disorder: reliability and validity of a new diagnostic category. J Consult Clin Psychol 62:381-6 |
| Walsh, B T; Hadigan, C M; Wong, L M (1992) Increased pulse and blood pressure associated with desipramine treatment of bulimia nervosa. J Clin Psychopharmacol 12:163-8 |
| Walsh, B T; Hadigan, C M; Devlin, M J et al. (1991) Long-term outcome of antidepressant treatment for bulimia nervosa. Am J Psychiatry 148:1206-12 |
| Walsh, B T; Wong, L M; Pesce, M A et al. (1990) Hyperamylasemia in bulimia nervosa. J Clin Psychiatry 51:373-7 |
| Walsh, B T; Gladis, M; Roose, S P et al. (1988) Phenelzine vs placebo in 50 patients with bulimia. Arch Gen Psychiatry 45:471-5 |
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