From: ulrike@gmd.de (Ulrike Bauer)
Newsgroups: sci.med
Subject: Re: More fluoxetine and bulimia
Date: 27 Jul 92 14:35:17 GMT
Organization: GMD, Sankt Augustin, Germany

In <1992Jul26.223844.1@amherst.edu> akcobb@amherst.edu writes:

>Is there any medicine that can actually inhibit the vomiting
>action?  I ask in relation to treatment of bulimia with Prozac
>(fluoxetine); I have known people to actually not be able to
>vomit, even after a physically painful binge, after being on
>Prozac for 2-4 weeks.  Is this as unfounded as it seems?
>Perhaps it is just psychological somehow.

>Thanks for any comments.


I've watched the discussion about bulimia and fluoxetine. And I don't
understand a lot of things. At first, what kind of medicine/treatment is
Prozac or fluoxetine? 

If I have understood everything right that was posted, in my opinion, 
it is not a question of not vomiting any longer, if you suffer from 
bulimia. I think with this only the symptoms will be combatted, but not 
the problems that have caused them. So this won't help the persons that 
have bulimia. 
Having these binges is a kind of reacting on stress, trying to escape 
the problems you are convinced not to be able to solve. It's like a drug,
once you have learned this mechanism, it's almost impossible to stop it.
After such a binge, many patients get very angry about themselves and 
depressive. They are afraid of getting very fat. To get rid of the 
depression, they vomit after such a binge. If you try to prevent these 
patients from vomiting by giving them Prozac or something like that, 
you enlarge depression. I think this can be very dangerous, as these 
persons suffering from bulimia are anyway at risk committing suicide.

Besides these symptoms are an outlet for not being able to cope with the 
problems these people have. If they aren't allowed to eat and vomit any 
more, they will become very restless, depressive, aggressive (also to 
themselves, for example by hurting themselves) or they only will become 
sick in another way, a psychosomatic illness like migraines or something
like that. But these symptoms will differ from person to person. 
So I think it would be better to make a psychotherapy and let the 
patients learn other mechanisms to cope with their problems step by step
without some medical treatment. The task of psychtherapy is to work 
out with the clients why and when they eat and vomit, so that they are
able - in the long run - to recognize these situations before binges will 
begin. Then the patients can decide whether they want to eat and vomit or 
if they try to put it off. These delays will last a few painful hours at 
the beginning, then perhaps a day (sometimes and sometimes you will start
eating straight on), then about a couple of days. At the end, after some 
years, binges will only be every few months. I don't know. It depends on 
the patient. And it is a very hard way for the bulimic person. But you 
can go it without some medicine - that's my opinion.

             Ulrike

--
Ulrike Bauer	ulrike.bauer@gmd.de	(+49 2241) 14-2437
German National Research Center for Computer Science (GMD)          -- o
Research Group for Adaptive Systems - FIT.KI.AS                   _`\<, _
Schloss Birlinghoven, P.O. Box 1316, D-5205 St. Augustin 1, FRG	 (_)/  (_)
Newsgroups: sci.med