title: Milnacipran in the treatment of bulimia nervosa: a report of 16 cases.
abstract: Controlled trials in patients with bulimia nervosa have demonstrated efficacy of antidepressant medications with serotonergic function (e.g. fluoxetine) as well as noradrenergic function (e.g. desipramine). Sixteen out-patients with bulimia nervosa according to DSM-IV criteria were treated in a drug surveillance with 100 mg of milnacipran, a specific serotonin and noradrenaline reuptake inhibitor (SNRI). Ten patients completed the 8-week observation period. The reasons for premature attrition were improvement in one patient (no. 12), a generalized exanthema in one patient (no. 7), severe nausea in one patient (no. 8) and non-compliance due to non-drug-related reasons in three patients (no. 1, 2, and 16). An intent-to-treat analysis exhibited a significant reduction in weekly binge eating and vomiting frequency from baseline to the end of treatment. Three patients stopped binge eating and purging completely during the last week of treatment. Furthermore, there was a concomitant decrease of depression ratings (HAMD, BDI). Our preliminary data give rise to the notion that milnacipran may be promising in the treatment of bulimia nervosa.
authors.affiliation: Department of General Psychiatry, University Hospital of Psychiatry, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Nadia
authors.initials: N
authors.lastname: El-Giamal
authors.forename: Martina
authors.initials: M
authors.lastname: de Zwaan
authors.forename: Ursula
authors.initials: U
authors.lastname: Bailer
authors.forename: Alexandra
authors.initials: A
authors.lastname: Strnad
authors.forename: Petra
authors.initials: P
authors.lastname: Schüssler
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D002032:Bulimia / Q000188:drug therapy* / Q000523:psychology*; D003521:Cyclopropanes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005247:Feeding Behavior / Q000187:drug effects / Q000523:psychology; D005260:Female; D006801:Humans; D000078764:Milnacipran; D018709:Statistics, Nonparametric
chemical_list: D000928:Antidepressive Agents; D003521:Cyclopropanes; D000078764:Milnacipran