Trygstad O
Section for Pediatric and Adolescent Endocrinology, Rikshospitalet Norway.
Acta Psychiatr Scand Suppl. 1990;361:34-7. doi: 10.1111/j.1600-0447.1990.tb11082.x.
The neuro-transmitter serotonin seems to be important in the treatment of disturbed eating behaviour. In Anorexia Nervosa (AN) a serotonin antagonist has been proposed, whereas in Bulimia Nervosa (BN) serotonin agonists have been used with success, e.g. fenfluramine. A new generation of antidepressants has been introduced. that selectively have a serotonergic effect. The previous tricyclic and particularly the tetracyclic antidepressants had a noradrenergic effect as well. Fluoxetine belongs to the new generation. A total of 30 females with BN were treated with fluoxetine in an open study. Clinical effect was observed after 2 to 6 weeks. One patient discontinued after 3 weeks, the other were treated for 3 to 10 months. A moderate effect with 75% reduction of bingeing and purging was observed in 15 patients, 14 stopped bingeing and purging. There was no serious side effects. However, drug treatment alone had no significant effect. The fluoxetine treatment is not instead of, but in addition to the traditional behavioral treatment with strict limits regarding food and meals.
神经递质血清素在治疗饮食紊乱行为方面似乎很重要。在神经性厌食症（AN）中，有人提出使用血清素拮抗剂，而在神经性贪食症（BN）中，血清素激动剂已成功使用，例如芬氟拉明。新一代抗抑郁药已经问世，它们具有选择性血清素能效应。以前的三环类抗抑郁药，尤其是四环类抗抑郁药也具有去甲肾上腺素能效应。氟西汀属于新一代药物。在一项开放性研究中，共有30名患有BN的女性接受了氟西汀治疗。2至6周后观察到临床效果。1名患者在3周后停药，其他患者接受了3至10个月的治疗。15名患者出现了中等程度的效果，暴饮暴食和催吐行为减少了75%，14名患者停止了暴饮暴食和催吐。没有严重的副作用。然而，单独使用药物治疗没有显著效果。氟西汀治疗不是取代传统的行为治疗，而是作为其补充，传统行为治疗对食物和饮食有严格限制。
