Sertraline treatment of Bulimia Nervosa

Control trials show that fluoxetine is effective in Eating Disorders, particularly in bulimia nervosa. Despite the relative paucity of evidence other selective serotonine reuptake inhibitors (SSRIs) than fluoxetine are commonly used to treat bulimia nervosa in clinical practice. Sertraline is one of the SSRIs being used in Eating Disorders with binging and purging behaviors. Available evidence show promising data about the effect of sertraline on eating disorder’s psychopatology, but there seem to be contrasting data about sertraline’s effect on body weight: There is a case reports of 5 cases of sertraline use in Binging-Purging Type Anorexia (AN BP) (G. Frank, W. H. Kaye, M. D. Marcus 2001) and there’s an open controlled study on eleven cases of Restricter Type Anorexia (AN R) (Santonastaso P, Friederici S, Favaro A. 2001) where the authors suggest that sertraline may have particular effectiveness in terms of weight restoration. On the other and hand there are a few studies on the efficacy of Sertraline in eating disorder symptoms associated with weight loss in BN and in Binge Eating Disorder (BED) (Sloan et al 2004 ; Milano et al 2004, Carter et al, 2003; Leombruni et al 2006).

Given the increasing evidence of Sertraline’s efficacy in Eating Disorder it is still unclear its effect on body weight: in some studies sertraline treatment seems to result in weight gain, while in others the same drug seems to induce weight loss. In order to give further evidence on this issue we published a case report series of seven normal weight outpatients with BN with sertraline treatment. In our sample subjects with sertraline treatment had an average body weight reduction of 2,4 Kg and an average BMI reduction of 0,9 during 12 weeks. The decrease of body weight that we observed in these cases would be in line with studies reporting improvement in eating disorders symptoms associated with significant weight loss in patients with Eating Disorder receiving Sertraline treatment (Leombruni et al 2006; McElroy et al 2000) and with studies reporting sertraline treatment of obesity (Appolinario et al 2004 ; Leombruni et al 2008)) and with studies reporting sertraline treatment of obesity (Appolinario et al 2004 ; Leombruni et al 2008).

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