"Hi, my name is [Your Name], I’m one of the medical students. Before we start, I’ll just wash my hands and put on some PPE. Can I confirm your full name and date of birth?"
"I understand you’ve been diagnosed with bulimia nervosa, and we’re here to discuss a treatment option called an SSRI. Is that alright with you?"
"To make sure this is helpful for you, can I ask—what do you already know about SSRIs, or do you have any concerns or expectations about starting medication for your bulimia?"
"Have you taken any medications for your mood or bulimia before? How have things been for you recently?"
"SSRIs, or selective serotonin reuptake inhibitors, are a group of medications that help increase levels of serotonin—a chemical in the brain linked to mood, emotions, and behaviour. In conditions like bulimia nervosa, serotonin levels can be low or unbalanced, which may contribute to mood changes and eating habits."
"SSRIs like fluoxetine are taken once a day, ideally at the same time each day. It may take 4–6 weeks before you notice the full benefit, so don’t worry if you don’t feel better straight away."
"It’s important to continue the SSRI even if you start feeling better. We usually recommend continuing for several months after your mood improves to reduce the risk of symptoms returning. If you ever wish to stop, let us know so we can gradually reduce the dose—don’t stop suddenly as it may cause withdrawal symptoms."
"Common side effects can include upset stomach, diarrhoea, headaches, weight change, feeling sleepy or sometimes trouble sleeping. Occasionally, people notice their mood feels a little worse before it gets better, but this is usually temporary."
"SSRIs can increase the risk of bleeding in your stomach, especially if taken with painkillers like ibuprofen or other NSAIDs. If you ever need pain relief, check with your doctor or pharmacist first, and never start an NSAID without medical advice."
"We’ll keep an eye on your symptoms and side effects, and you’ll have regular reviews. Please let us know if you feel worse, have troubling side effects, or want to stop. Don’t stop abruptly."
"So in summary: SSRIs help balance serotonin, which can improve mood and support treatment of bulimia. Take it daily, give it several weeks to work, and don’t stop suddenly. Can you tell me what you’ll remember about your SSRI, just to check I explained it clearly?"
"Here’s a leaflet you can take home, and you can always find more information online from the NHS or Beat Eating Disorders charity. Any other questions or worries you’d like to talk about?"
"Thank you for your time today. I’ll now take off my PPE and wash my hands. If you need anything else, just ask."