Bulimia nervosa is characterized by a cyclic binge eating pattern followed by depression, self-induced vomiting and diarrhea. The primary treatment of choice for patients with bulimia nervosa is fluoxetine, which is a selective serotonin reuptake inhibitor (SSRI). Tricyclic antidepressants, i.e. amitriptyline, and monoamine oxidase inhibitors, i.e. phenelzine, are not routinely given to bulimic patients because of the risks of toxicity or overdose. Methylphenidate is used to treat attention deficit hyperactivity disorder.