Unregistered User If this is not your name, click here.
		Contact Us | Order Now | Journals | Bookstore | Register a colleague
	Select a ChannelAcneAIDS and HIVAllergy OtherAlzheimer'sAnaesthesiology OtherAngina Pectoris/MIAnxietyArthritis OtherAsthmaBack PainBacterial InfectionsBladder CancerBone Marrow TransplantationBreast CancerCardiology OtherCataractCell TransplantationCervical CancerCholesterol/Lipid disordersCirrhosisClinical PharmacologyColorectal CancerCongestive Heart FailureContact DermatitisContraceptionCOPDCystic FibrosisDental and Oral DisordersDepressionDermatology OtherDiabetesDialysisEating DisordersElbowEmergency MedicineEndocrinology OtherEpilepsyErectile DysfunctionFibromyalgiaGastro OtherGeneticsGenitourinary OtherGeriatricsGERD/GastritisGlaucomaH. Pylori/UlcerHaematology OtherHair LossHeadachesHepa/Biliary OtherHepatitisHipHRTHypertensionIBDImmunologyInfectious OtherInfertilityIntensive CareIrritable Bowel SyndromeKneeLeukemiasLiver CancerLung CancerLupusLymphomasMelanomaMenopauseMultiple Sclerosis Nephrology OtherNeurologic OtherNutritional / Metabolic OtherOb/Gyn OtherObesityOncology OtherOphth. OtherOphthalmic SurgeryOrgan TransplantationOrthopaedics OtherOsteoarthritisOsteoporosisOtitisOtorhino. OtherOvarian CancerPaediatricsPainPancreatic CancerParkinson'sPregnancyProstate CancerPsychiatry OtherPulmonary OtherRadiologyRenal CancerRenal FailureRespiratory InfectionsRheumatoid arthritisRheumatology OtherRhinitisSchizophreniaShoulderSleep ApnoeaSleep DisordersSpineStrokeSTDsSurgeryThyroid DisordersTransfusionTransplant Surgery OtherTraumaUrinary IncontinenceUrinary tract infectionsVaccinologyVascular DisordersViral Infections

SEARCH   News Bookstore Medline The Web Meetings & Congresses Complete Doctor's Guide    EXPLORE :    All News   All Webcasts   All Cases   All Meetings & Congresses   All Medical Resources New drugs / indications English Dictionary Medical Dictionary Thesaurus Warning | Privacy | Awards  Favourite Journals  Click here to choose your favourite journals  Favourite Sites  Click here to choose your favourite sites  Languages  Select languageEnglishFrançais

Use of Anti-Depressant Does Not Decrease Risk of Relapse of Anorexia Nervosa CHICAGO, IL -- June 14, 2006 -- Use of the anti-depressant fluoxetine did not help patients with anorexia nervosa who had restored their body weight maintain that weight or reduce their risk of relapse, according to a study in the June 14 issue of Journal of the American Medical Association (JAMA). Anorexia nervosa is an eating disorder primarily affecting young women and marked by an extreme fear of becoming overweight that leads to excessive dieting to the point of serious ill-health and sometimes death. It is a serious psychiatric illness with a lifetime death rate arguably as high as that associated with any psychiatric illness, according to background information in the article. A major contributor to the poor prognosis of this illness is the high rate of relapse, with 30 to 50% of patients requiring rehospitalization within 1 year of discharge after successful weight restoration. This has prompted interest in interventions aimed at preventing relapse following weight restoration. A substantial number of patients with anorexia nervosa receive antidepressant medications. Fluoxetine was initially marketed under the brand name of Prozac. B. Timothy Walsh, M.D., of New York State Psychiatric Institute/Columbia University Medical Center, New York, and colleagues compared fluoxetine with placebo to determine the rate of relapse and behavioral recovery following initial treatment for anorexia nervosa. The trial included 93 patients with anorexia nervosa who had received intensive inpatient or day-program treatment and regained weight to a minimum body mass index (BMI) of 19.0. Participants were then randomly assigned to receive fluoxetine (n = 49) or placebo (n = 44) and were treated for up to 1 year as outpatients. The researchers found that similar percentages of patients assigned to fluoxetine and to placebo maintained a BMI of at least 18.5 and remained in the study for 52 weeks (fluoxetine: 26.5%; placebo: 31.5%). The most conservative analysis of time-to-relapse found no significant difference between the fluoxetine and placebo groups in time-to-relapse. At 52 weeks, 45% of the placebo group and 43% of the fluoxetine group had not relapsed. "The current study has implications for both clinical practice and research. The present findings, coupled with those of previously published studies, indicate that the common practice of prescribing antidepressant medication is unlikely to provide substantial benefit for most patients with anorexia nervosa, either when they are underweight or immediately upon weight restoration. These data imply that therapeutic efforts would be better devoted to psychological and behavioral interventions for which there is some, albeit modest, evidence of efficacy," the authors write. "Future research on the utility of novel psychological treatments and innovative psychotropic and nonpsychotropic medications is obviously needed." This study was supported in part by grants from the National Institutes of Health. Eli Lilly supplied fluoxetine and placebo. Editorial: Fluoxetine Treatment of Anorexia Nervosa - Important but Disappointing Results In an accompanying editorial, Scott J. Crow, MD, of the University of Minnesota, Minneapolis, comments on the findings of the study examining the use of fluoxetine for anorexia nervosa. "The study by Walsh et al is an important contribution that addresses a major gap in research on anorexia nervosa and provides vital information about a fairly common treatment practice for this illness. Unfortunately, it appears that fluoxetine provides no benefit in the relapse prevention treatment of anorexia nervosa. Despite a prevalence rate similar to many other psychiatric illnesses, and particularly in light of the high mortality associated with anorexia nervosa, there is a serious underrepresentation of anorexia nervosa in biomedical research. Much more information is needed on the treatment of individuals with anorexia nervosa while they are at low weight. In addition, strategies must be developed to help individuals who recover to stay in recovery." Dr. Crow reports having received research support from Eli Lilly, Abbott Laboratories, GlaxoSmithKline, Ortho McNeil Pharmaceuticals, Pfizer, and Bristol-Myers Squibb; consultant fees from Ortho McNeil Pharmaceuticals; and honoraria from Pfizer. JAMA. 2006;295:2605-2612. JAMA. 2006;295:2659-2660. SOURCE: American Medical Association E-mail this page to a friend or colleague! To print, use this version