title: The eating disorders medicine cabinet revisited: a clinician's guide to ipecac and laxatives.
abstract: OBJECTIVE
  To describe the frequency of alternative medication use in bulimia nervosa (BN), and to review available nonprescription emetic (ipecac) and laxative products and their potential toxicities.
  
  
  METHODS
  Survey data were collected from 39 consecutive treatment-seeking patients with BN or subthreshold BN. Survey data of the available nonprescription and herbal products from local retail stores were also collected. Toxicology information was reviewed on these agents from MEDLINE and herbal textbooks.
  
  
  RESULTS
  Ipecac use occurred in 18% of the 39 patients. Laxatives had been used at some point to control weight or "get rid of food" by 67% of the patients. Of these, 31% had abused laxatives during the month prior to evaluation. In the product survey, 248 laxative-containing products were identified.
  
  
  CONCLUSIONS
  There are numerous laxative products readily available to patients, and many of them have significant associated toxicities. Patients with BN tend to endorse high rates of laxative use. While ipecac is used infrequently, it can have deleterious consequences. Patients with BN should be screened for use of both ipecac and laxatives and should be educated about the potential consequences associated with the misuse of these agents.
authors.affiliation: Neuropsychiatric Research Institute, Fargo, North Dakota 58107, USA. ksteffen@nrifargo.com
authors.forename: Kristine J
authors.initials: KJ
authors.lastname: Steffen
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: James L
authors.initials: JL
authors.lastname: Roerig
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Lancaster
mesh_terms: D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects*; D004639:Emetics / Q000008:administration & dosage / Q000009:adverse effects*; D001068:Feeding and Eating Disorders / Q000628:therapy*; D006801:Humans; D007486:Ipecac / Q000008:administration & dosage / Q000009:adverse effects*; D012646:Self Administration; D012651:Self Medication
chemical_list: D002400:Cathartics; D004639:Emetics; D007486:Ipecac