Which medication is considered first-line treatment for bulimia nervosa?

Fluoxetine is recognized as the first-line treatment for bulimia nervosa, primarily due to its effectiveness in reducing the frequency of binge-eating episodes and purging behaviors. Studies have shown that selective serotonin reuptake inhibitors (SSRIs), like fluoxetine, can help improve overall mood and decrease the symptoms associated with this eating disorder. Fluoxetine has also been found to be effective in addressing the co-occurring psychological factors, such as depression and anxiety, that often accompany bulimia nervosa.

In contrast, other medications listed do not have the same level of empirical support for treating bulimia nervosa. Desipramine, a tricyclic antidepressant, may not be as beneficial as SSRIs for this specific condition. Diazepam and lorazepam, which are benzodiazepines, are typically used for anxiety and as muscle relaxants, but they do not address the underlying issues of eating disorders and may even contribute to dependency concerns. Hence, fluoxetine is preferred due to its favorable profile in specifically targeting the symptoms of bulimia nervosa.