Bulimia is an eating disorder characterized by a pattern of episodic binge-eating. Patients with this eating disorder frequently demonstrate depressive symptoms when seen for evaluation. A familial association between bulimia and affective disorders has also been suggested. The authors report a placebo-controlled, double-blind trial of amitriptyline hydrochloride in a series of 32 female outpatients who satisfied DSM-III criteria for bulimia. The results of this study indicated that amitriptyline hydrochloride at a dosage of 150 mg at bedtime had significant antidepressant activity in this group of patients. Patients in both the placebo and active drug group also received a minimal behavioral treatment program in addition to drug therapy. Both groups demonstrated considerable improvement in eating behavior. The magnitude of this improvement was dramatic and not anticipated. The drug was well tolerated and was not associated with weight gain or increased carbohydrate craving.
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