Article

An Open Trial of Olanzapine in Anorexia Nervosa

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 12/2004; 65(11):1480-2. DOI: 10.4088/JCP.v65n1106
Source: PubMed

ABSTRACT

Recent reports raise the possibility that olanzapine can assist weight gain and improve behavioral symptoms during refeeding in anorexia nervosa.
Seventeen DSM-IV anorexia nervosa subjects hospitalized between May 1999 and October 2000 were enrolled in open-label treatment with olanzapine for up to 6 weeks. Baseline weight and symptoms were compared to patients' status at the end of treatment.
Olanzapine administration was associated with a significant reduction in depression, anxiety, and core eating disorder symptoms, and a significant increase in weight. A comparison with our historical data suggests that subjects in this study had a significantly greater decrease in depression.
These data lend support to the possibility that olanzapine may be useful in treating anorexia nervosa. However, a controlled trial is necessary to demonstrate that olanzapine is efficacious.

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    • "Recent findings suggest that drugs targeting both 5-HT and DA receptors may be effective in treating AN. Several open label studies have reported that the atypical antipsychotic olanzapine (OLZ) increases body weight, and reduces hyperactivity and anxiety about eating and body shape (Barbarich et al, 2004; Dennis et al, 2006; Leggero et al, 2010). Furthermore, two preliminary RCTs recently showed that OLZ significantly reduces obsessions about weight while increasing the rate of weight gain (Bissada et al, 2008), and reduces anorexic ruminations (Mondraty et al, 2005). "
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    ABSTRACT: Anorexia nervosa (AN) is an eating disorder characterized by extreme hypophagia, hyperactivity, and fear of weight gain. No approved pharmacological treatments exist for AN despite high mortality rates. The activity-based anorexia (ABA) phenomenon models aspects of AN in rodents, including progressive weight loss, reduced food intake, and hyperactivity. First, we optimized the ABA paradigm for mice. We compared mouse strains (Balb/cJ, A/J) for susceptibility with ABA, and evaluated the effects of different food access durations (2, 4, 6, 8, and 10 h) on ABA parameters. Balb/cJ mice exhibited significantly shorter survival time (days until 25% bodyweight loss) in the ABA paradigm compared with A/J mice. Furthermore, 6 h of food access reduced survival in mice housed with wheels without reducing survival in mice housed without wheels. We then evaluated the effects of chronic treatment with fluoxetine (4 weeks) or subchronic treatment with olanzapine (OLZ) (1 week) on ABA in BALB/cJ mice. OLZ (12 mg/kg/day) significantly increased survival and reduced food anticipatory activity (FAA). However, OLZ did not alter food intake or running wheel activity during ad-lib feeding (baseline) or restriction conditions, or in mice housed without wheels. Fluoxetine (18 mg/kg/day) increased food intake and reduced FAA, but did not alter survival. Here, we report for the first time that OLZ, but not fluoxetine, reduces ABA in mice. Our findings indicate further need for clinical investigations into the effects of OLZ, but not selective serotonin reuptake inhibitors, on core features of AN.
    No preview · Article · Mar 2012 · Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology
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    • "Recent findings suggest that drugs targeting both 5-HT and DA receptors may be effective in treating AN. Several open label studies have reported that the atypical antipsychotic olanzapine (OLZ) increases body weight, and reduces hyperactivity and anxiety about eating and body shape (Barbarich et al, 2004; Dennis et al, 2006; Leggero et al, 2010). Furthermore, two preliminary RCTs recently showed that OLZ significantly reduces obsessions about weight while increasing the rate of weight gain (Bissada et al, 2008), and reduces anorexic ruminations (Mondraty et al, 2005). "
    Klenotich · SJ · Seiglie · MP · McMurray · MS · Roitman · JD · Le Grange · Dugad · Dulawa SC

    Full-text · Article · Jan 2012 · Neuropsychopharmacology
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    • "Increased body weight, metabolic, endocrine, sexual and cardiovascular are the most common side effects. Some of them can be used in favour of the patient, as was the case of the patient with the increased body weight (Barbarich et al. 2004). "
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    ABSTRACT: Like any other patient, a schizophrenic patient can get a physical illness, too. As such patients tend to ignore reality and neglect themselves and are stigmatized by society, due to which their physical symptomatology is often ignored, physical illness can remain undetected. If the schizophrenic patient is observed and adequate care is provided by the family, family doctor and a psychiatrist, it is possible to recognize the physical illness and intervene promptly. We are presenting a case of a female patient who has been treated for schizophrenia for a number of years. The treatment was mostly ambulatory (i.e. the patient was hospitalized twice) and consisted of first-generation antipsychotics. During the past two years, for reasons unknown, the patient stopped taking regular meals and as a result lost significant body weight, became apathetic and withdrawn, started avoiding social contacts and neglected personal hygiene. She reportedly took the psychopharmaca regularly, but rarely attended psychiatric follow-up consultations. Due to substantial weight loss and hypotonia, correction of antipsychotic was made and internist treatment administered. The choice of olanzapine was not an accidental one. We decided to take advantage of its side effect for the treatment of an anorectic syndrome. Interdisciplinary cooperation proved to be a justified decision.
    Preview · Article · Mar 2011 · Psychiatria Danubina
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