ABSTRACT
This chapter reviews status of both psychopharmacologic and psychotherapeutic interventions for bulimia, and examines the limited attempts to date to compare the relative efficacies of these two types of treatments. It offers some practical guidelines concerning the clinical management of the patients, focusing on the outpatient setting where most patients can be successfully treated. Cognitive behavioral therapy has played a prominent role in treatment studies for bulimia nervosa since it was first adapted for use in eating disorders. Most controlled trials of antidepressants for bulimia nervosa have found the active treatment superior to placebo; only the J. E. Mitchell and R. Groat study using amitriptyline and Sabine et al.’s study using mianserin failed to convincingly demonstrate superiority. A few studies have compared the relative efficacies of pharmacologic and psychotherapeutic interventions, and although some of the results are conflicting, psychotherapy appears to exert a stronger effect, at least on a short-term basis.
