How Do Antidepressants Treat Bulimia?

More than for the treatment of depression, antidepressant medication has become a helpful and effective part in the recovery process for bulimia recovery.

How do antidepressant medications function, and how can they be a useful part of treatment for an individual recovering from bulimia?

Antidepressants include a wide-range of medications, including the following:

  • Selective Serotonin Reuptake Inhibitors (SSRIs): Most commonly prescribed antidepressant medication. Functions by increasing the level of serotonin in the body. Drugs in this class include Celexa, Lexapro, Prozac, Paxil, and Zoloft.
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs): These antidepressant medications function by increasing the amount of serotonin and norepinephrine in the brain by blocking the re-absorption of those neurotransmitters [1]. Trade brands of SNRIs include Effexor, Cymbalta, and Yentreve.
  • Tricyclic antidepressants: Among the earliest antidepressants compounded, these medications also function by making neurotransmitters more readily available in the brain, which in turn boosts mood. Trade brands of these classes of medications include Norpramin, Tofranil, Pamelor, and Vivactil.
  • Monoamine Oxidase Inhibitors: These medications work by decreasing the amount of monoamine oxidase, which is a enzyme that breaks down neurotransmitters. The effect of this helps improve depression symptoms. Brand name MOIs include Marplan, Laniazid, Aurorix, and Azilect.

doctor with pill bottle in hand

How Do These Work for Bulimia Treatment?

While commonly used to treat major depressive disorders, anxiety disorders, obsessive compulsive disorder, and other chronic conditions, antidepressants have become an effective part of treatment for bulimia.

Several randomized controlled research trials have demonstrated the usefulness of antidepressant medication in reducing binge eating and purging urges in patients with bulimia nervosa.

Also in patients with bulimia, antidepressant medications have been shown to be helpful in decreasing body image and weight concerns, in addition to reducing depression and anxiety, which are commonly experienced in people who have bulimia [2]. This includes treatment with various classes of antidepressant medications, as listed above.

The Role of Fluoxetine

The most common antidepressant medication studied and prescribed for the treatment of bulimia is fluoxetine, known by the brand name Prozac.

In fact, fluoxetine is currently the only antidepressant medication approved by the Food and Drug Administration (FDA) for bulimia treatment, as it has been shown to decrease the frequency of binge eating and vomiting.

Research has demonstrated that many individuals who suffer with bulimia have a chemical imbalance of the neurotransmitter Serotonin, which is responsible for regulating emotions, mood, and appetite.

The imbalance of serotonin levels in the body can increase urges to binge and purge in women and men who have bulimia, and antidepressant medications can decrease these urges by effectively balancing the levels of neurotransmitters in the brain.


The Negative Side-Effects of Antidepressant Use

Antidepressants, like all other medications, may produce negative side effects. The most commonly experienced side effects include dry mouth, nausea, drowsiness, fatigue, insomnia, constipation, and loss of sexual desire.

If you or someone you love is considering the use of antidepressant medication for the treatment of bulimia, it is important to thoroughly discuss this option with your physician.

While antidepressants can be a helpful part of treatment, these medications are much more effective for bulimia treatment when coupled with psychotherapy, such as cognitive behavioral treatment.

Finding the Right Treatment for Each Individual

Medication can be a part of the puzzle in the recovery process from bulimia. To learn if an antidepressant medication is appropriate for you, talk to your treatment team or eating disorder specialist more about this.

In some individuals, finding the correct antidepressant and dosage may take a trial phase, and your doctor may need to make adjustments to your prescription before finding a protocol that works best for you.

As with all medications, it is necessary to remain under the supervision of a physician, who can monitor signs and symptoms that you may be experiencing as a result of your prescription.

Addressing All of the Needs of the Individual

It is important to remember that since bulimia is a complex psychiatric illness, treatment must address various concerns on multiple levels: the physical/biological, emotional, and psychological.

Achieving total and complete healing involves work with a multi-disciplinary team, which can be one of the greatest tools for treatment and recovery.

Contributor: Crystal Karges, MS, RDN, IBCLC for Eating Disorder Hope


  1. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), Accessed 7 Nov 2014
  2. Zhu AJ, Walsh BT. Pharmacologic treatment of eating disorders. Can J Psychiatry 2002;47:227-34.

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 19th, 2014
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