What Sorts of Medications Are Available for Bulimia Treatment?

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The editorial staff of American Addiction Centers is made up of credentialed clinical reviewers with hands-on experience in or expert knowledge of addiction treatment.
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What medications might be involved in my bulimia treatment program?

Prozac is the only medication approved by the FDA for the treatment of bulimia. But your doctor might use other medications “off label” to help, including Zoloft and Paxil.

Most clinicians agree that participating in a therapy program is one of the best ways to address bulimia.

Research bears out that opinion. For example, in a study conducted by the ECRI Institute, researchers compared the effectiveness of Cognitive Behavioral Therapy and medications, attempting to determine which was more effective in helping people with bulimia to control their urge to binge and/or purge. Researchers found that therapy did a much better job.

Studies like this demonstrate the real power of enrolling in a therapy program for bulimia. It is here that people can pick up skills they need in order to control bulimia for good. But some clinicians do use medications as a way to augment the work their clients are doing in therapy. Some people find that the medications they take while in therapy help them to feel calm, collected, and in control. That could help these people to really recover from bulimia.


Common Medication Choices

Mayo Clinic reports that there is only one medication that has been approved by the Food and Drug Administration for the treatment of bulimia. That medication is fluoxetine, sold under the brand name Prozac.

This medication is a type of selective serotonin reuptake inhibitor (SSRI), which is commonly provided to people who have either mild or moderate symptoms of depression.

While the FDA has only approved one medication, clinicians might use other medications in order to help their clients. These “off-label” prescriptions are both legal and ethical, although they come with a few disclaimers. Doctors who prescribe medications in this way may not have reams of research papers to rely upon when they’re asked to explain how the drugs work. They may be using these medications based on just one study, or based on anecdotal evidence that the medications might help some people at some time.

Various medications could be used in an off-label format for the treatment of bulimia, but Psych Central reports that two medications are often used in the fight against bulimia: sertraline (Zoloft) and paroxetine (Paxil). These medications are not in the same class as Prozac, but they are also used in order to help people with depression.


Why Antidepressants?

Using antidepressant medications in the fight against bulimia is not a new practice. In fact, according to research in the Psychiatric Times, the practice began in the 1980s and 1990s, when researchers found that using these medications was effective. In these early studies, researchers saw dips in bingeing/purging behavior of 50-75 percent in those who got antidepressant therapy. Those dips are impressive, and they seem to suggest that medications could provide at least some level of relief.

That relief could be due, in part, to the fact that bulimia is often tied to undiagnosed mental illness. An article in Current Psychiatry suggests that depression, especially major depression, is considered a common co-occurring mental health disorder in people who have bulimia. That issue could be going on well under the surface, making bulimia worse.

A bulimia binge does not appear out of the blue, for no reason. Often, the need to binge and purge comes about due to negative thought patterns. People with bulimia might feel as though they are:

  • Fat
  • Unlovable
  • Stupid
  • Forgettable

These people do not have effective coping skills, so when these thoughts pop into their heads, they feel incredibly upset and ill at ease, and they may have no way to turn those negative feelings around. They are consumed by them, until they take action by bingeing. After bingeing, they feel guilty enough to purge.

Depression can make negative self-talk much more likely, and depression can make those negative thoughts and feelings much harder to ignore. Treating that underlying depression could help people to feel just one less prompt to binge, and that could make purging unnecessary.

Similarly, many antidepressants have a sedating effect, so people taking them often feel sleepy and slow. A mind that is sedated in this manner might be less likely to spin away into despair on a prompt, as the mind may simply not have the energy to accomplish such a spin. People taking antidepressants may be able to fall asleep faster, which might allow them to awaken feeling refreshed and more capable the next day. Someone like this might be less vulnerable to a binge simply because this person had a chance to rest.

Some clinicians think, too, that there is an obsessive/compulsive aspect to the thoughts that surround bulimia. Some people with bulimia create very elaborate rituals involving what they can eat, how they can eat, and how they can purge. They may feel as though they should handle every one of these steps in the same way, or something terrible will happen. Since many antidepressants assist with obsessive thoughts like this, the medications could be a good choice for people with bulimia.



Working with Medications

While it’s easy to understand why medications might be a good choice for some people, they are not the right choice for all people. They do come with some side effects that people can, and do, find at least a little bit unpleasant.

According to Psych Central, common side effects associated with antidepressants include:

  • Decreased sex drive
  • Insomnia
  • Constipation
  • Sleepiness
  • Sweating
  • Dizziness
  • Weight gain
  • Tremors
  • Dry mouth

The weight gain aspect of antidepressants could be particularly concerning for people with bulimia, particularly if these people are working hard to keep weight levels within a specific range. Adding in a medication that could change the number on the scale could be hard for some people to contemplate.

Antidepressants also need time to build up within the body before they take hold, and according to Scientific American, some people do not find relief until they have taken antidepressants for weeks. Stopping the medication too early could slow the induction process down even farther, and in some cases, it could stop the help of antidepressants altogether.

So people who take these medications will need to stay in close contact with their doctors. If side effects are an issue, switching to a different medication or a different dose might help. If the medications do not provide relief after a set period of time, using a different medication formulation might also be a useful step.

It is vital for people taking these medications to follow a meal plan as specified by a doctor. Eating too much or too little could impede the work of the medications, as might gaining or losing weight. People will need to attend to these issues carefully, so they can make the right decision for their bodies. A doctor’s meal plan might help.



A Good Choice

People with bulimia have a great deal of choice when it comes to treatment and recovery. They could choose a program that includes medications, or they could look for programs that do not rely on any pharmaceutical support. Either option is valid. The real key is to get help.

Disclaimer: Facilities in the American Addiction Centers family do not treat bulimia.


Last Updated on June 17, 2019
Editorial Staff
Editorial Staff
The editorial staff of American Addiction Centers is made up of credentialed clinical reviewers with hands-on experience in or expert knowledge of addiction treatment.
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