Combination of antidepressants and psychological treatments for bulimia nervosa: a systematic review.
This review assessed the effect of a combination of antidepressants plus psychological approaches compared to each single treatment for bulimia nervosa.


METHODS
Trials were included in two meta-analyses: single antidepressants versus combination and single psychological approaches versus combination. Methodological quality and homogeneity of results were assessed. Dichotomous outcomes were analysed by calculating relative risks (RR).


RESULTS
Five trials were included in meta-analysis 1 and 7 in meta-analysis 2. Remission rates were 42% for combination versus 23% for antidepressants (RR = 1.38; 95% CI=0.98-1.93; P=0.06) and 36% for psychological approaches compared to 49% for combination (RR= 1.21; P=0.03). Drop-out rates were 16% for psychological approaches and 30% for combination (RR =0.57; 95% CI = 0.38-0.088; P=0.11).


CONCLUSIONS
Efficacy of combined treatments was superior to single approaches. When antidepressants were combined to treatment, acceptability of psychological approaches was significantly reduced.
Bacaltchuk
J
J
Federal University of São Paulo, UNIFESP-EPM, Brazil.
Trefiglio
R P
RP
Oliveira
I R
IR
Hay
P
P
Lima
M S
MS
Mari
J J
JJ
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002032:Bulimia / Q000628:therapy*; D003131:Combined Modality Therapy; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors
D000928:Antidepressive Agents