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BMJ 2006; 332 doi: (Published 22 June 2006) Cite this as: BMJ 2006;332:1500
  1. Alison Tonks, associate editor (

    Fluoxetine does not prevent relapse of anorexia nervosa

    Antidepressants such as fluoxetine are a common treatment for anorexia nervosa, even though there's no evidence that they help with weight gain. A new trial has found that fluoxetine doesn't prevent relapses either, a disappointing result given the high rate of relapse and the high risk of all cause mortality associated with this common mental illness. The trial was relatively small (n = 93) but well done, and a linked editorial (pp 2659-60) describes it as convincingly negative. Compared with placebo, fluoxetine did not prolong remission in women aged 16-45 who had recovered after initial treatment. Time to relapse was similar in both groups, and only 26.5% of the women taking fluoxetine and 31.5% of those taking a placebo managed to continue with treatment and keep their body mass index above 18.5 during the trial, which lasted one year. All the participants had cognitive behaviour therapy.

    Credit: JAMA

    As expected, dropout rates were high. Only 40 of the 93 women completed their course of treatment. They were equally likely to drop out of placebo and treatment groups.

    The editorial says this trial leaves doctors with few if any drug options for young women with anorexia, partly because the research effort so far has not matched the importance of this disease. Anorexia is associated with a higher risk of suicide than any other mental illness.

    New treatment for rotavirus looks promising

    Nitazoxanide is an antidiarrhoeal agent already licensed in the United States to treat diarrhoea caused by Cryptosporidium spp and Giardia spp. It also seems to work against rotavirus, the commonest cause of life threatening diarrhoea in children worldwide. In a small randomised trial sponsored by the drug's manufacturer, nitazoxanide halved the time it took for Egyptian children to get better after being admitted to hospital with severe rotavirus infection. The 38 children who took part had …

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