Although I have seen it. I have seen patients who have been binging and purging for 20 years, spontaneously remit without any therapy. So it does happen. Don t know very much about monitoring income. These studies are usually done short term Very quickly, I m sure it will be common sense to you, but choose an agent based upon side effect profile.
Many agents are useful.
See what your patient tolerates. There has been really very little comparative data available in terms of what works better, so I would just go with what a patient tolerates and wants to take. If the patient doesn t respond to one medication, by all means, try another one. Really, the only medication that clearly works is fluvoxamine. Desipramine has been studied in non-purging bulimia.