Answer B. Bulimia nervosa and binge eating disorder
The FDA approved fluoxetine for the treatment of bulimia nervosa after this SSRI showed significant efficacy in reducing binge eating and purging behaviors, even in the absence of comorbid depressive disorder.1
Interestingly, fluoxetine was more efficacious for symptoms of bulimia nervosa at a dosage of 60 mg daily than 20 mg daily (the typical dosage for treating depression). However, in a relapse-prevention study in which patients with anorexia nervosa had recently successfully completed full weight restoration through inpatient treatment, fluoxetine was no different than placebo in preventing relapse.2
Pharmacotherapy remains an important treatment modality for comorbid mood and eating disorders. Given the improvement in mood symptoms with re-nourishment, weight restoration is recommended before evaluation for the need for medication.
1. Fluoxetine Bulimia Nervosa Collaborative Study Group. Fluoxetine in the treatment of bulimia nervosa: a multicenter, placebo-controlled, double-blind trial. Arch Gen Psychiatry. 1992;49:139-147.
2. Walsh BT, Kaplan AS, Attia E, et al. Fluoxetine after weight restoration in anorexia nervosa: a randomized controlled trial. JAMA. 2006;295:2605-2612.
For more on this topic, see “The Interplay of Mood Disorders and Eating Disorders” by Blair Uniacke, MD and Allegra Broft, MD," on which this quiz is based.