Bulimia, tricyclic antidepressants, and mania

Anorexia nervosa and bulimia are common conditions that are difficult to treat effectively. Psychopharmacologic agents, particularly tricyclic antidepressants, are now being used as adjunctive therapy in bulimia. The case of a 15-year-old girl with bulimia who was treated with imipramine and had a severe (and first) manic episode is presented. The complication of drug-induced mania observed in patients treated with tricyclic antidepressants is discussed.