In a patient with bulimia nervosa, which medication is contraindicated?

Bupropion is contraindicated in patients with bulimia nervosa due to its potential to increase the risk of seizures, particularly in individuals who engage in purging behaviors. Patients with bulimia often experience electrolyte imbalances, especially from vomiting or laxative use, which can further heighten the risk of seizures when bupropion is administered. This makes it a particularly risky choice for treating any condition in someone diagnosed with bulimia nervosa.

In contrast, fluoxetine, nortriptyline, and sertraline are all considered safe and effective treatment options for bulimia nervosa. Fluoxetine is an SSRI that has shown efficacy in reducing episodes of binge eating and purging behaviors, and it is often the first-line treatment. Nortriptyline, a tricyclic antidepressant, has been used as well, although it is less common than SSRIs. Sertraline, another SSRI, has also been researched and is known to help with similar symptoms. Therefore, the contraindication associated with bupropion highlights an important aspect of medication management in patients with eating disorders.