CPG for Eating Disorders

Summary of the EvidenceSRSE 311++SRSE 311++SRSE 311++SRSE 311++SRSE 311++SRSE 311++The fluoxetine dose (60 mg/day) administered over 6 to 18 weeks has managed,in all moderate (1+) and high quality (1++) RCT, to reduce binge-eating andpurging as well as psychological symptoms related with eating disorders in ashort period of time.Fluoxetine at 60mg/day obtains better results than a 20mg/day dose (FluoxetineBulimia Nervosa Collaborative Study Group, 1992) 292 ; this dose is also associatedwith relapse prevention in a study with a considerable amount of discontinuation.There is considerable evidence of the short-term effect of fluoxetine treatment(60mg/day) in patients with BN. There is no evidence of the effectiveness oflong-term treatment or the optimal duration of treatment.Some studies have reported remissions in a small number of patients treatedexclusively with pharmacological treatment, which leads us to borne in mindthat although symptoms improve, they persist in time and do not disappear.In an RCT (Walsh, 1991) 286 it was reported that patients with greater body massand weight and longer disease length responded better to desipraminetreatment.In the study Fluoxetine Bulimia Nervosa Collaborative Study Group,1992 292 , patients with greater weight responded better in all treatment groups.Recommendations(See also recommendations 9.GPH.1. to 9.GPH.6.)B 9.9.2.1.1. Patients should be informed that antidepressant treatment can reduce thefrequency of binge-eating and purging episodes but effects are notimmediate. (Adopted from recommendation 7.3.6.2. of the NICE guide).B 9.9.2.1.2. In the treatment of BN pharmacological treatments other thanantidepressants are not recommended. (Adopted from recommendation7.3.6.4. of the NICE guide).D 9.9.2.1.3. The dose of fluoxetine used in patients with BN is greater than the doseused for treating depression (60 mg/day). (Adopted from recommendation7.7.6.5. of the NICE guide).CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS144