Treatment of bulimia nervosa with citalopram: A randomized controlled trial

Bulimia nervosa (BN) is one of the most frequent eating disorders in industrialized societies. Re-duced serotonin activity has been suggested to trigger some of the cognitive and mood distur-bances associated with BN. Therefore, pharmacological treatment of BN is mainly based on the use of selective serotonin reuptake inhibitors, that have proved effective. The biological basis of this disorder fully are not established yet. The aim of this randomized controlled trial was to verify the efficacy of citalopram, a selective serotonin reuptake inhibitor, in a group of BN diagnosed patients. Twenty female outpatients, with an age range of 19-28 years having BN-binge purging, as defined by the DSM IV, were assigned randomly into two treatment groups; the first group received 20-40 mg/day citalopram for 12 weeks and the second group had placebo. The study was conducted for 12 weeks with weekly clinical assessments. At the end of the observation period, the group treated with citalopram showed a statistically significant reduction in the number of binge-eating crisis and purging with respect to the group who received the placebo only. In no case, treatment was interrupted for any emergency reasons. This study indicates that citalopram is well tolerated and equally effective in reducing binge-eating crisis and purging in patients with BN