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Double-blind, placebo-controlled studies suggest that antidepressants are at least as useful in the treatment of BED as in BN. Early placebo-controlled studies found desipramine to be effective in reducing binge eating, with an abstinence rate of 60% (McCann and Agras 1990). Studies of SSRIs suggest moderate efficacy for fluoxetine, sertraline, and citalopram (Appolinario and McElroy 2004; McElroy et al. 2000). Other studies have found no effect for fluoxetine on binge eating (Devlin et al. 2005; Grilo et al. 2005b). These conflicting results may be due to the relatively high placebo response observed in some studies. There has also been considerable variability in weight losses experienced by patients with BED treated with antidepressants, from essentially no weight loss to several pounds. Although the McCann and Agras (1990) study found that antidepressants reduced binge eating, patients who stopped binge eating did not lose weight. In another controlled study, 108 overweight women with BED received 3 months of CBT, followed by 6 months of weight-loss treatment combined with desipramine. No additive effect of desipramine on binge eating was found; however, women in the medication group lost significantly more weight (4.8 kg) than those in the comparison group (Agras et al. 1994b).

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