Fluoxetine after weight restoration in anorexia nervosa: A randomized controlled trial

B. Timothy Walsh, Allan S. Kaplan, Evelyn Attia, Marion Olmsted, Michael K. Parides, Jacqueline C. Carter, Kathleen M. Pike, Michael J. Devlin, Blake Woodside, Christina A. Roberto, Wendi Rockert

Research output: Contribution to journalArticle

269 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)2605-2612
Number of pages8
JournalJournal of the American Medical Association
Volume295
Issue number22
DOIs
StatePublished - Jun 14 2006
Externally publishedYes

Fingerprint

Fluoxetine
Anorexia Nervosa
Randomized Controlled Trials
Weights and Measures
Placebos
Body Mass Index
Recurrence
Outcome Assessment (Health Care)
Cognitive Therapy
Therapeutics
General Hospitals
Antidepressive Agents
Psychiatry
Inpatients
Outpatients
Pharmacology
Psychology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Fluoxetine after weight restoration in anorexia nervosa : A randomized controlled trial. / Walsh, B. Timothy; Kaplan, Allan S.; Attia, Evelyn; Olmsted, Marion; Parides, Michael K.; Carter, Jacqueline C.; Pike, Kathleen M.; Devlin, Michael J.; Woodside, Blake; Roberto, Christina A.; Rockert, Wendi.

In: Journal of the American Medical Association, Vol. 295, No. 22, 14.06.2006, p. 2605-2612.

Research output: Contribution to journalArticle

Walsh, BT, Kaplan, AS, Attia, E, Olmsted, M, Parides, MK, Carter, JC, Pike, KM, Devlin, MJ, Woodside, B, Roberto, CA & Rockert, W 2006, 'Fluoxetine after weight restoration in anorexia nervosa: A randomized controlled trial', Journal of the American Medical Association, vol. 295, no. 22, pp. 2605-2612. https://doi.org/10.1001/jama.295.22.2605
Walsh, B. Timothy ; Kaplan, Allan S. ; Attia, Evelyn ; Olmsted, Marion ; Parides, Michael K. ; Carter, Jacqueline C. ; Pike, Kathleen M. ; Devlin, Michael J. ; Woodside, Blake ; Roberto, Christina A. ; Rockert, Wendi. / Fluoxetine after weight restoration in anorexia nervosa : A randomized controlled trial. In: Journal of the American Medical Association. 2006 ; Vol. 295, No. 22. pp. 2605-2612.
@article{610da48ca9e14f87a7fd15486ba60fe2,
title = "Fluoxetine after weight restoration in anorexia nervosa: A randomized controlled trial",
abstract = "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.",
author = "Walsh, {B. Timothy} and Kaplan, {Allan S.} and Evelyn Attia and Marion Olmsted and Parides, {Michael K.} and Carter, {Jacqueline C.} and Pike, {Kathleen M.} and Devlin, {Michael J.} and Blake Woodside and Roberto, {Christina A.} and Wendi Rockert",
year = "2006",
month = "6",
day = "14",
doi = "10.1001/jama.295.22.2605",
language = "English (US)",
volume = "295",
pages = "2605--2612",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "22",

}

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 K.

AU - Carter, Jacqueline C.

AU - Pike, Kathleen M.

AU - Devlin, Michael J.

AU - Woodside, Blake

AU - Roberto, Christina A.

AU - Rockert, Wendi

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.

UR - http://www.scopus.com/inward/record.url?scp=33745099049&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33745099049&partnerID=8YFLogxK

U2 - 10.1001/jama.295.22.2605

DO - 10.1001/jama.295.22.2605

M3 - Article

C2 - 16772623

AN - SCOPUS:33745099049

VL - 295

SP - 2605

EP - 2612

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 22

ER -