Prozac Failed Anorexic Women in Study

By LINDSEY TANNER

CHICAGO – Prozac is one of the antidepressants often used to treat anorexia, but researchers found it didn’t stop young women from resuming their self-starving ways.

In a small study, more than half of the women who got Prozac or dummy pills dropped out of the experiment, and few who remained in it kept their weight from dropping into the danger zone. The results underscore the difficulty in curing the troubling eating disorder.

Taken with previous findings, the results indicate the common practice of prescribing antidepressants “is unlikely to provide substantial benefit for most patients with anorexia,” the researchers wrote. Their report was in Wednesday’s Journal of the American Medical Association.

The study follows a research review in April from the government’s Agency for Healthcare Research and Quality, which found that no drug effectively treats anorexia. That report said a few behavior treatments can help, including psychotherapy that encourages patients to develop thinking patterns to counteract their unhealthy eating behavior.

The Prozac results aren’t surprising because anorexia “is considered one of the most treatment-resistant mental illnesses,” said Ellen Astrachan-Fletcher, a therapist and director of the Eating Disorders Clinic at the University of Illinois at Chicago.

In the new study, which lasted a year, the women first had psychiatric treatment and had put on enough weight to be in the normal range before being given Prozac or placebos. About 27 percent of the 49 participants randomly assigned Prozac maintained a normal weight and finished the study versus 32 percent of 44 women on dummy pills; the differences were not statistically significant. Also, 25 Prozac users and 28 placebo patients dropped out because of weight loss or dissatisfaction with treatment.

One patient, a 17-year-old on Prozac, attempted suicide. While antidepressants have been linked with suicidal behavior in children, the researchers noted that depression often accompanies anorexia, and that anorexia has one of the highest suicide rates of any psychiatric illness.

Several of the researchers, including lead author Dr. Timothy Walsh of New York State Psychiatric Institute, have received funding from Prozac maker Eli Lilly and Co., which provided the study pills. Funding for the research came from the National Institutes of Health.

Anorexia affects a little over 1 percent of U.S. females and less than 1 percent of males. The National Eating Disorders Association estimates that about 10 million girls and women and about 1 million boys and men have anorexia or bulimia, a related eating disorder involving food bingeing and vomiting for which Prozac has shown some success.

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On the Net:

JAMA: http://jama.ama-assn.org

National Eating Disorders Association: http://www.edap.org