ABSTRACT
OBJECTIVE: The authors' goal was to confirm that brain serotonin (5-HT) alterations are present in patients who have recovered from bulimia nervosa. Positron emission tomography imaging with [(18)F]altanserin was used to characterize binding of the 5-HT(2A) receptor, which might contribute to altered feeding, mood, or impulse control. METHOD: Nine women who had recovered from bulimia nervosa (they had no episodes of binge eating or purging, were at normal weight, and had regular menstrual cycles for more than 1 year) were compared with 12 female volunteers who had never had bulimia. RESULTS: The healthy volunteers, but not the women who had recovered from bulimia nervosa, had an age-related decline in 5-HT(2A) binding. Women who had recovered from bulimia nervosa had a reduction of medial orbital frontal cortex 5-HT(2A) binding. CONCLUSIONS: The lack of age-related changes in 5-HT activity is further evidence of 5-HT alterations in subjects who have recovered from bulimia nervosa. In addition, vulnerabilities for eating disorders, impulse dyscontrol, and mood disturbances may involve 5-HT and frontal lobe activity.
Subject(s)
Bulimia/diagnosis , Bulimia/metabolism , Cerebral Cortex/diagnostic imaging , Ketanserin/analogs & derivatives , Receptors, Serotonin/metabolism , Adolescent , Adult , Age Factors , Age of Onset , Bulimia/diagnostic imaging , Cerebral Cortex/chemistry , Cerebral Cortex/metabolism , Female , Fluorine Radioisotopes , Frontal Lobe/chemistry , Frontal Lobe/diagnostic imaging , Frontal Lobe/metabolism , Humans , Receptor, Serotonin, 5-HT2A , Receptors, Serotonin/analysis , Tomography, Emission-Computed/statistics & numerical dataABSTRACT
OBJECTIVE: Recent data suggest that serotonin selective reuptake inhibiter (SSRI) medication is useful in preventing relapse in weight-restored anorexics. Our clinical impression has been that SSRIs are not effective in patients who are underweight with anorexia nervosa. METHOD: In order to determine whether there was any benefit for SSRI medication in underweight anorexics, we compared two groups of underweight anorexics upon admission to our inpatient hospital using a retrospective chart review. RESULTS: Sixty percent of anorexic patients were taking an SSRI upon admission to our inpatient hospital. The 24 subjects taking an SSRI were compared to the 16 subjects not taking an SSRI. These two groups had similar ages and body weights as well as scores for measures of anxiety and depression and most core eating disorder symptoms. DISCUSSION: These results suggest that SSRI medication had no effect on clinical symptoms of malnourished underweight anorexics.
