Effects of fluvoxamine on depression, anxiety, and other areas of general psychopathology in bulimia nervosa

The efficacy of fluvoxamine in maintaining improvement of general psychopathology (depression, obsessive-compulsive symptoms, anxieties, interpersonal trust, and body perception) was tested in a double-blind placebo-controlled study of 72 patients with bulimia nervosa who were being treated successfully with inpatient behavioral psychotherapy. Over a period of about 15 weeks (2-3 weeks inpatient titration phase, 12 weeks outpatient relapse-prevention phase), fluvoxamine or placebo were given. The relapse-prevention design was used to avoid potential confounding effects of other concomitant treatments. Assessments concerning general psychopathology were made on the basis of expert ratings (CGI, HDRS) and self ratings (HSCL, Eating Disorders Inventory (EDI)-subscales ''ineffectiveness,'' ''perfectionism,'' ''maturity fears,'' ''interpersonal distrust,'' and ''interoceptive awareness''). Fluvoxamine had significant effects in preventing relapse as measured on the basis of the Clinical Global Impression (CGI) scale ''severity of illness'', and a positive trend for relapse preventing effects was observed for the HSCL ''general symptomatic index''. Further, a relapse preventing effect was observed for the HSCL subscale ''obsessive-compulsive symptoms'', but not for the EDI subscale ''perfectionism''. Various dependent variables measuring depression showed no significant relapse-preventing effects of fluvoxamine, but only positive trends. Fluvoxamine had no relapse preventing effects according to our results for dependent variables assessing anxieties, interpersonal trust, and body perception. During a final short (4-week) off- medication phase, no statistically significant effects of discontinuation of medication, but some trends in the expected directions, were observed.