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Fluoxetine in Bulimia — MRCPsych Paper B MCQ

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ModerateEating DisordersFluoxetine in BulimiaMRCPsych Paper B

A 22-year-old woman with bulimia nervosa is receiving eating-disorder-focused cognitive behavioural therapy (CBT-ED). The clinical team is reviewing the role of adjunctive fluoxetine. Which statement best reflects current UK guidance and licensed product information?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Fluoxetine 60 mg daily may be used alongside psychotherapy to reduce binge-eating and purging

Explanation lettering: D = shown as A · C = shown as B · B = shown as C · E = shown as D · A = shown as E

B is correct. The UK SmPC indicates fluoxetine as a complement to psychotherapy for reducing binge-eating and purging in adults with bulimia nervosa; the recommended dose is 60 mg daily. Evidence of efficacy is from short-term trials, and efficacy beyond 3 months has not been demonstrated. NICE NG69 does not specifically recommend fluoxetine or its dose, but states that medication must not be offered as the sole treatment. Therefore, psychological treatment remains central. A is incorrect because fluoxetine is not sole first-line treatment. C is unsupported because SSRIs do not have equivalent evidence or licensed status. D gives the usual depression dose rather than the recommended bulimia dose. E is too absolute because medication can have an adjunctive role.

Reference: Electronic Medicines Compendium, Fluoxetine 60 mg Capsules, Summary of Product Characteristics, sections 4.1, 4.2 and 5.1, updated 2026. https://www.medicines.org.uk/emc/product/7088/smpc