Normal-weight bulimic patients have disturbed appetite, mood, and
neuroendocrine function and often respond to antidepressants. Since these
findings suggest abnormalities in brain monoaminergic pathways, the authors
measured CSF monoamine concentrations in 27 normal-weight bulimic patients
and 14 volunteers. Bulimic patients had a significantly lower mean CSF
norepinephrine concentration. Levels of CSF 5-HIAA, the major serotonin
metabolite, and CSF HVA, the major dopamine metabolite, were normal,
although more frequent binge-eating in bulimic subjects was associated with
a significantly lower CSF HVA level. Whether trait- or state-related,
monoaminergic disturbances are part of this disorder's neurobiological
syndrome. The lower CSF norepinephrine concentration suggests bulimia is
not simply a variant of affective disorders.
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