title: Use of nutritional supplements to increase the efficacy of fluoxetine in the treatment of anorexia nervosa.
abstract: OBJECTIVE
  Selective serotonin reuptake inhibitor (SSRI) medication does not appear to be effective in ill, malnourished anorexia nervosa (AN) patients. However, it may be effective in preventing relapse after weight restoration. The purpose of this study was to determine whether nutritional supplements could potentiate the effects of fluoxetine in underweight AN subjects.
  
  
  METHODS
  Twenty-six subjects with AN participated in a trial of fluoxetine. In a double-blind, placebo-controlled manner, subjects received either nutritional supplements or a nutritional placebo. The nutritional supplement included tryptophan (the precursor of serotonin), vitamins, minerals, and essential fatty acids believed to influence serotonin pathway function.
  
  
  RESULTS
  There was no significant difference in weight gain between subjects treated with fluoxetine plus nutritional supplements versus fluoxetine plus a nutritional placebo. Moreover, there were no significant differences between groups on mean changes in anxiety or obsessive and compulsive symptoms.
  
  
  CONCLUSIONS
  The results of this study suggest that supplement strategies are not a substitute for adequate nutrition and are ineffective in increasing the efficacy of fluoxetine in underweight AN subjects.
authors.affiliation: Department of Psychiatry, University of Pittsburgh Medical School, Anorexia and Bulimia Nervosa Research Module, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Barbarich
authors.forename: Claire W
authors.initials: CW
authors.lastname: McConaha
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Halmi
authors.forename: Kelly
authors.initials: K
authors.lastname: Gendall
authors.forename: Suzanne R
authors.initials: SR
authors.lastname: Sunday
authors.forename: Jill
authors.initials: J
authors.lastname: Gaskill
authors.forename: Maria
authors.initials: M
authors.lastname: La Via
authors.forename: Guido K
authors.initials: GK
authors.lastname: Frank
authors.forename: Sarah
authors.initials: S
authors.lastname: Brooks
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Plotnicov
authors.forename: Walter H
authors.initials: WH
authors.lastname: Kaye
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000188:drug therapy / Q000628:therapy*; D003131:Combined Modality Therapy; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000627:therapeutic use; D004311:Double-Blind Method; D004537:Eicosanoic Acids / Q000627:therapeutic use; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D005473:Fluoxetine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D044623:Nutrition Therapy / Q000379:methods*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D014364:Tryptophan / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D004281:Docosahexaenoic Acids; D004537:Eicosanoic Acids; D005395:Fish Oils; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors; D014364:Tryptophan; D014815:Vitamins; C094477:arachidic acid