Antidepressants versus psychotherapy for bulimia nervosa: a systematic review

Antidepressants versus psychotherapy for bulimia nervosa: a systematic review

Author Bacaltchuk, Josué Autor UNIFESP Google Scholar
Trefiglio, R. P. Google Scholar
Oliveira, I. R. de Google Scholar
Lima, M. S. Google Scholar
Mari, J. J. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade Federal da Bahia (UFBA)
Fed Univ Pelotas
Abstract Objective: To assess the efficacy and acceptability of antidepressants compared to psychotherapy as single approaches for the treatment of bulimia nervosa. Method: Dichotomous outcomes were analysed by calculating relative risks and continuous outcomes by calculating effect sizes. the number needed to treat (or harm) was calculated. Methodological quality of trials and heterogeneity in the results were evaluated.Results: A meta-analysis including five randomized controlled trials showed a non-significant difference in short-term remission of bulimic symptoms favouring psychotherapy. Remission rates were 20% for antidepressants and 39% for psychotherapy (P = 0.07). Dropout rates were higher (P = 0.027) for antidepressants (40%) than for psychotherapy (18%). the number needed to harm (NNH) was 4.Discussion: Psychotherapy was superior to antidepressants, but using a more conservative statistical approach this difference, although clinically relevant, was not significant. the number of trials might be insufficient to show the significance of a 20% absolute risk reduction in efficacy. Psychotherapy was a better accepted treatment.
Language English
Date 1999-02-01
Published in Journal of Clinical Pharmacy and Therapeutics. Oxford: Blackwell Science Ltd, v. 24, n. 1, p. 23-31, 1999.
ISSN 0269-4727 (Sherpa/Romeo, impact factor)
Publisher Blackwell Science Ltd
Extent 23-31
Origin http://dx.doi.org/10.1046/j.1365-2710.1999.00192.x
Access rights Closed access
Type Article
Web of Science ID WOS:000079884400005
URI http://repositorio.unifesp.br/handle/11600/26032

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