Which medication should be avoided in the treatment of both anorexia and bulimia?

Wellbutrin, also known as bupropion, is contraindicated in the treatment of both anorexia and bulimia due to its association with an increased risk of seizures, especially in individuals with eating disorders who may have electrolyte imbalances or are significantly underweight. In patients with anorexia and bulimia, these imbalances can occur due to malnutrition and purging behaviors.

Using Wellbutrin in such cases can heighten the risk of seizure activity, making it a dangerous choice for these populations. On the other hand, medications like fluoxetine are typically used because they can help with symptoms of depression and anxiety often associated with eating disorders and have a more favorable safety profile when used appropriately.

Methylphenidate and atomoxetine, while they are stimulant and non-stimulant ADHD medications respectively, do not have the same seizure risk concerns as Wellbutrin but are generally not first-line treatments for anorexia or bulimia. Fluoxetine, as a selective serotonin reuptake inhibitor, has evidence supporting its use for bulimia. Thus, Wellbutrin’s risk profile makes it the medication that should be avoided in treating both disorders.