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Also tell your doctor if you have or have ever had ulcers or bleeding in your stomach or intestines. According to guidelines from the American Psychiatric Association (APA), small controlled trials demonstrate topiramate's effectiveness as a treatment for bulimia nervosa. Robbins M, Marais R, Wilson AP, Felmingham D. The risk or severity of adverse effects can be increased when Doxepin is combined with Fluspirilene. It is most commonly used as contraceptionВ in combined oral contraceptivesВ (COC), also known as birth control, to prevent pregnancy after sex. Given that route of nutrition cannot be masked, blinding of the physicians and nurses was not feasible.