Imipramine in the treatment of bulimia: A double-blind controlled study

Abstract

There were 22 bulimic women who participated in a double‐blind placebo‐controlled study of the effects' of imipramine hydrochloride in the treatment of bulimia over a 16 week period. Particpants receiving the active drug demonstrated a significantly greater reduction in purging (frequency of self‐induced vomiting plus the use of laxatives) at both the 6 and 16 week assessment periods. Depression was reduced to a significantly greater extent in those receiving the active drug at 6 weeks but not at the 16 week assessment. These findings, from the longest duration medication study in this condition, suggest that imipramine is an effective treatment for bulimia. However, only one‐third of the participants receiving imipramine had stopped purging by the end of the study. Thus, clinicians may need to add other approaches, such as cognitive‐behavioral treatment, to the management of this condition.

A review of the controlled trials of pharmacotherapy and psychotherapy in the treatment of bulimia nervosa

“…Mitchell and Groat (1984) actually found that depressed subjects improved less when treated with amitriptyline that nondepressed subjects. In other studies Walsh et al (1988), Kennedy et al (1988), Agras et al (1987, and even Pope et al (1988) all found no relationship between concurrent major depressive diagnosis and the effectiveness of various antidepressants in the treatment of bulimia nervosa. Therefore, the preponderance of evidence indicates that the antidepressant effect may not be sufficient to explain the improvement in bulimic subjects treated with antidepressants, and that it is unlikely that bulimia nervosa is simply an affective variant in all cases, although this may certainly be true in a subgroup of subjects.…”

Changes in self-reported food intake in bulimics as a consequence of antidepressant treatment

“…Subjects in this investigation were 22 females over the age of 18 years who met DSM-I11 criteria for bulimia and were the participants in a previously reported double-blind placebo-controlled study of the efficacy of imipramine in treating bulimia (Agras et al, 1987). Exclusion criteria were (1) a diagnosis of concurrent anorexia nervosa, (2) significant suicidal ideation, (3) a previous Food Intake 78 1 history of the use of antidepressants for bulimia, and (4) age under 18.…”

Cluster B personality disorder characteristics predict outcome in the treatment of bulimia nervosa

“…Wilson, Rossiter, Kleifield, and Lindholm (1986) reported that nonresponders to cognitive-behavioral treatment had significantly lower self-reported past weights than treatment responders. Similarly, Agras, Dorian, Kirkley, Arnow, and Bachman (1987) found that in bulimics treated with imipramine, those with lower reported body mass indices (BMIs) did less well than those with higher BMIs. Fairburn, Kirk, OConnor, Anastasiades, and Cooper (1987), found that self-esteem, as measured by the Rosenberg Self-Esteem Scale (Rosenberg, 1965), was a significant predictor of treatment out-…”