Combination of antidepressants and psychological treatments for bulimia nervosa: a systematic review
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2000-04-01
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Bacaltchuk, Josué 
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Background: This review assessed the effect of a combination of antidepressants plus psychological approaches compared to each single treatment for bulimia nervosa.Method: Trials were included in two meta-analyses: single antidepressants versus combination and single psychological approaches versus combination. Methodological quality and homogeneity of results were assessed. Dichotomous outcomes were analysed by calculating relative risks (RR).Results: Five trials were included in meta-analysis I and 7 in meta-analysis 2. Remission rates were 42% for combination versus 23% for antidepressants (RR = 1.38; 95% CI = 0.98-1.93; P = 0.06) and 36% for psychological approaches compared to 49% for combination (RR = 1.21; P = 0.03). Drop-out rates were 16% for psychological approaches and 30% for combination (RR = 0.57; 95% CI = 0.38-0.088; P = 0.11).Conclusion: Efficacy of combined treatments was superior to single approaches. When antidepressants were combined to treatment, acceptability of psychological approaches was significantly reduced.
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Acta Psychiatrica Scandinavica. Copenhagen: Munksgaard Int Publ Ltd, v. 101, n. 4, p. 256-264, 2000.