Olanzapine treatment of an adolescent girl with anorexia nervosa

Ercan, Eyüp Sabri; Copkunol, Hakan; Cýkoethlu, Sibel; Varan, Azmi

doi:10.1002/hup.492

Cited by 27 publications

(14 citation statements)

References 7 publications

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“…Treatments using typical antipsychotics alone or in combination with psychotherapies, many of them evaluated in open trials and without placebo (PL) control, have usually failed (Dally, 1966;Vandereyken and Pierlot, 1982;Vandereyken, 1984;Ruggero et al, 2001;Cassano et al, 2003). More recently, atypical antipsychotics, olanzapine (OLA), risperidone and amisulpride, in particular, in either single cases or in small patient groups, had been shown to improve eating habits, weight and some psychopathological aspects of AN (depression, anxiety, obsessivity-compulsivity, psychoticism) (Hansen, 1999;Newman Tocker, 2000;Ridley-Siegert, 2000;La Via et al, 2000;Coates, 2000;Gaskill et al, 2001;Mehler et al, 2001;Ruggero et al, 2001;Leucht et al, 2002;Jensen and Mejihede, 2002;Powers et al, 2002;Carver et al, 2002;Ercan et al, 2003;Malina et al, 2003;Boachie et al, 2003;Pederson et al, 2003;Mangano et al, 2004;Barbarich et al, 2004;Mondraty et al, 2005;Attia et al, 2005;Hillebrand et al, 2005;Menaster, 2005;Bosanac et al, 2005). But as these therapies were administered in open trials without PL control, the significance of the positive results is questionable.…”

Section: Introductionmentioning

confidence: 96%

Olanzapine therapy in anorexia nervosa: psychobiological effects

Brambilla

Segura-Garcia

Fassino

et al. 2007

International Clinical Psychopharmacology

120

131

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Dopamine impairments occur in anorexia nervosa. The aim of this study was to see whether treatment with the atypical dopamine antagonist antipsychotic olanzapine improves the disorder. Thirty anorexics, 18 restricted and 12 bingeing-purging, underwent a 3-month course of cognitive behavioral therapy, plus at random and double-blinded oral olanzapine (2.5 mg for 1 month, 5 mg for 2 months) in half and oral placebo in the other half of them. BMI, psychopathological aspects (eating disorder inventory, Hamilton Rating Scale, Buss-Durkee Rating Scale, Yale Brown Cornell for Eating Disorders Rating Scale, temperament-character inventory), and homovanillic acid blood concentrations for dopamine secretion, were monitored at baseline and then monthly during the trial. At the end of the trial BMI, total eating disorder inventory, total Yale Brown Cornell for Eating Disorders Rating Scale, Buss-Durkee Rating Scale, Hamilton Rating Scale scores and in olanzapine-treated patients the subitems of eating disorder inventory ineffectiveness and maturity fear, of Buss-Durkee Rating Scale direct aggressiveness, of temperament-characteristic inventory persistence had improved significantly. When stratified for anorexia nervosa subtype, BMI changes were significant among anorexia nervosa bingeing-purging patient, 'depression' (Hamilton Rating Scale) and 'direct aggressiveness' (Buss-Durkee Rating Scale) among anorexia nervosa bingeing-purging patients, 'persistence' (temprerament-characteristic inventory), among anorexics restricted patients, with a trend toward significance for obsessivity-compulsivity (Yale Brown Cornell for Eating Disorders Rating Scale). homovanilic acid blood levels increased significantly in the cognitive behavioral therapy+olanzapine group. No correlations were observed between homovanilic acid concentrations and psychopathological parameters. The pharmacological treatment can significantly improve specific aspects of anorexia nervosa.

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Section: Introductionmentioning

confidence: 96%

Olanzapine therapy in anorexia nervosa: psychobiological effects

Brambilla

Segura-Garcia

Fassino

et al. 2007

International Clinical Psychopharmacology

120

131

View full text Add to dashboard Cite

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“…Reports on risperdone are fewer but also suggest similar improvements in case studies and case series data (Beato Fernandez & Rodriquez Cano, 2005;Newman-Toker, 2000). Specific reports on the effectiveness of the atypical antipsychotics in children with AN are also few (Broachie, Goldfield, & Spettigue, 2003;Ercan, Copkunol, Cykoethlu, & Varan, 2003;Fisman, Steele, Short, Byrne, & Lavalle, 1996;Mehler et al, 2001). These reports suggest that olanzapine use was well tolerated and associated with weight gain and weight maintenance as well as decreases in agitation, mealtime anxiety, and overall compliance with treatment.…”

Section: Psychopharmacologic Interventionsmentioning

confidence: 59%

Effective interventions for adolescents with anorexia nervosa

Lock

Gowers

2005

Journal of Mental Health

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Background: Anorexia Nervosa (AN) is a serious psychiatric illness with both psychological and medical sequelae that usually onsets during adolescence. The illness presents formidable challenges to clinicians. Despite these facts, there are few treatments studies for the adolescent age group. Aims: This report provides a critical review of the most common treatments and the empirical support for them for adolescent AN. Method: Clinical and research literature was reviewed to identify empirically supported treatments with an emphasis on identifying pertinent randomized controlled trials. However, relevant clinically oriented reports and consensus clinical guidelines were also included when other systematic research was unavailable in order to provide a more comprehensive view of current treatment strategies for adolescents with AN. Results: There are only five randomized clinical trials specifically addressing treatment for adolescent AN. Only 207 subjects were enrolled in these studies with an average cell size of about 20 subjects. Data from these trials suggest that family therapy wherein parents re-feed their adolescent offspring is effective for AN in this age group. However, other treatment approaches (e.g. individual therapy, group therapy, hospitalization, medication) have not been sufficiently or systematically studied. Conclusions: Family therapy based on parental re-feeding is an effective approach for adolescent AN. However, the superiority of family therapy over other types of interventions has not been sufficiently demonstrated. There is an urgent need to conduct treatment research in this area to guide clinical care for this vulnerable population.

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“…This treatment lead to decreased body concerns, anxiety and sleep disturbances. Ercan, Copkunol, Cykoethlu, & Varan (2003) added olanzapine when fluoxetine 20 mg/ day (after clomipramine 75 mg/day) did not Copyright succeed in a 15-year-old girl, finally achieving improvements of BMI and overall psychological functioning. Interestingly, because of cardiac complications caused by anorexia, this patient was treated mainly on pediatric wards without receiving any psychotherapy, suggesting that olanzapine itself seems to be effective in anorexia nervosa psychopathology.…”

Section: Olanzapinementioning

confidence: 98%