TY - JOUR
T1 - Fluoxetine after weight restoration in anorexia nervosa
T2 - A randomized controlled trial
AU - Walsh, B. Timothy
AU - Kaplan, Allan S.
AU - Attia, Evelyn
AU - Olmsted, Marion
AU - Parides, Michael
AU - Carter, Jacqueline C.
AU - Pike, Kathleen M.
AU - Devlin, Michael J.
AU - Woodside, Blake
AU - Roberto, Christina A.
AU - Rockert, Wendi
N1 - Funding Information:
This was work supported by F31 NS092307 (K.D.M.), T32 NS007180-32 (K.D.M.), R01 NS060701 (G.F.R.), R21 NS099788 (G.F.R.), a gift from the F. M. Kirby Foundation, and Cancer Center Support Grant 5P30CA006927-53.
Funding Information:
We gratefully acknowledge Andreas Solomos for his input on experimental design and manuscript preparation. We also acknowledge the Fox Chase Cancer Center Laboratory Animal Facility, Irradiation Facility, and Flow Cytometry Facility. This was work supported by F31 NS092307 (K.D.M.), T32 NS007180-32 (K.D.M.), R01 NS060701 (G.F.R.), R21 NS099788 (G.F.R.), a gift from the F. M. Kirby Foundation, and Cancer Center Support Grant 5P30CA006927-53.
PY - 2006/6/14
Y1 - 2006/6/14
N2 - Context: Antidepressant medication is frequently prescribed for patients with anorexia nervosa. Objective: To determine whether fluoxetine can promote recovery and prolong time-to-relapse among patients with anorexia nervosa following weight restoration. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled trial. From January 2000 until May 2005, 93 patients with anorexia nervosa received intensive inpatient or day-program treatment at the New York State Psychiatric Institute or Toronto General Hospital. Participants regained weight to a minimum body mass index (calculated as weight in kilograms divided by the square of height in meters) of 19.0 and were then eligible to participate in the randomized phase of the trial. Interventions: Participants were randomly assigned to receive fluoxetine or placebo and were treated for up to 1 year as outpatients in double-blind fashion. All patients also received individual cognitive behavioral therapy. Main Outcome Measures: The primary outcome measures were time-to-relapse and the proportion of patients successfully completing 1 year of treatment. Results: Forty-nine patients were assigned to fluoxetine and 44 to placebo. Similar percentages of patients assigned to fluoxetine and to placebo maintained a body mass index of at least 18.5 and remained in the study for 52 weeks (fluoxetine, 26.5%; placebo, 31.5%; P = .57). In a Cox proportional hazards analysis, with prerandomization body mass index, site, and diagnostic subtype as covariates, there was no significant difference between fluoxetine and placebo in time-to-relapse (hazard ratio, 1.12; 95% CI, 0.65-2.01; P = .64). Conclusions: This study failed to demonstrate any benefit from fluoxetine in the treatment of patients with anorexia nervosa following weight restoration. Future efforts should focus on developing new models to understand the persistence of this illness and on exploring new psychological and pharmacological treatment approaches.
AB - Context: Antidepressant medication is frequently prescribed for patients with anorexia nervosa. Objective: To determine whether fluoxetine can promote recovery and prolong time-to-relapse among patients with anorexia nervosa following weight restoration. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled trial. From January 2000 until May 2005, 93 patients with anorexia nervosa received intensive inpatient or day-program treatment at the New York State Psychiatric Institute or Toronto General Hospital. Participants regained weight to a minimum body mass index (calculated as weight in kilograms divided by the square of height in meters) of 19.0 and were then eligible to participate in the randomized phase of the trial. Interventions: Participants were randomly assigned to receive fluoxetine or placebo and were treated for up to 1 year as outpatients in double-blind fashion. All patients also received individual cognitive behavioral therapy. Main Outcome Measures: The primary outcome measures were time-to-relapse and the proportion of patients successfully completing 1 year of treatment. Results: Forty-nine patients were assigned to fluoxetine and 44 to placebo. Similar percentages of patients assigned to fluoxetine and to placebo maintained a body mass index of at least 18.5 and remained in the study for 52 weeks (fluoxetine, 26.5%; placebo, 31.5%; P = .57). In a Cox proportional hazards analysis, with prerandomization body mass index, site, and diagnostic subtype as covariates, there was no significant difference between fluoxetine and placebo in time-to-relapse (hazard ratio, 1.12; 95% CI, 0.65-2.01; P = .64). Conclusions: This study failed to demonstrate any benefit from fluoxetine in the treatment of patients with anorexia nervosa following weight restoration. Future efforts should focus on developing new models to understand the persistence of this illness and on exploring new psychological and pharmacological treatment approaches.
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U2 - 10.1001/jama.295.22.2605
DO - 10.1001/jama.295.22.2605
M3 - Article
C2 - 16772623
AN - SCOPUS:33745099049
SN - 0002-9955
VL - 295
SP - 2605
EP - 2612
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
IS - 22
ER -