يستلزم الشره المرضي العصبي (ICD-11 6B81 / ICD-10 F50.2) نهجًا منظمًا قائمًا على الأدلة. تتقاطع إرشادات سريرية دولية متعددة على استراتيجية مشتركة تتضافر فيها التدخلات الدوائية والنفسية — إذ لا يُوصى بأيٍّ منهما كعلاج مستقل.
Among the recommendations for pharmacological treatment, seven out of eight guidelines consistently recommended antidepressants, specifically the SSRI fluoxetine, although with some restrictions (e.g., to use antidepressants in combination with psychotherapy).
Conflicting recommendations were obtained for the use of TCAs such as imipramine and desipramine, which were recommended by the WFSBP, while the guideline from the United States explicitly did not recommend TCAs for initial treatment in patients with BN.
The use of anticonvulsants, specifically topiramate, was consistently recommended by two guidelines, while the remaining guidelines did not report on anticonvulsants.
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