Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial

Attia, Evelyn; Steinglass, Joanna E.; Walsh, B. Timothy; Wang, Yuanjia; Wu, Peng; Schreyer, Colleen C.; Wildes, Jennifer E.; Yılmaz, Zeynep; Guarda, Ángela S.; Kaplan, Allan S.; Marcus, Marsha D.

doi:10.1176/appi.ajp.2018.18101125

Cited by 135 publications

(115 citation statements)

References 27 publications

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“…The paper in question, by Attia et al 1 and published in the American Journal of Psychiatry, reports the results of a randomized, double-blind, placebocontrolled trial of olanzapine in adults with anorexia nervosa. Patients receiving active drug showed a greater increase in body mass index per month than those receiving placebo, corresponding to about a pound more, or roughly 1.5 pounds total, per month.…”

mentioning

confidence: 99%

Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial

Attia

Steinglass

Walsh

et al. 2019

AJP

Self Cite

135

107

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See https://www.fda.gov/ForIndustry/Developing ProductsforRareDiseasesConditions/default.htm.Family-based psychotherapies have a robust evidence base of efficacy for treating younger patients, and adults often do well with cognitivebehavioral approaches delivered by experienced subspecialists. But refractory patients, who comprise a large number of the affected adult population, are extraordinarily difficult to treat.

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mentioning

confidence: 99%

Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial

Attia

Steinglass

Walsh

et al. 2019

AJP

Self Cite

135

107

View full text Add to dashboard Cite

show abstract

“…11 A recent large (n = 152) 16-weeks outpatient placebo-controlled trial of olanzapine (mean dose 7.77 mg/day) as a primary treatment for adults with anorexia nervosa found a moderate effect size on weight gain favouring the active drug. 20 However, the rate of weight gain was very small (approximately 0.7 kg/month) and negligible with placebo. There were no other significant differences on primary outcomes and only one secondary outcome difference for shape concerns favouring the placebo arm.…”

Section: Pharmacological Therapiesmentioning

confidence: 95%

Current approach to eating disorders: a clinical update

Hay

2020

Internal Medicine Journal

156

110

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This article presents current diagnostic conceptualisations of eating disorders, including new disorders such as binge eating disorder (BED) and avoidant/restrictive food intake disorder (ARFID). This is followed by contemporary findings in the epidemiology of eating disorders, their broad sociodemographic distribution and the increases in community prevalence. Advances and the current status of evidence-based treatment and outcomes for the main eating disorders, anorexia nervosa, bulimia nervosa and BED are discussed with focus on first-line psychological therapies. Deficits in knowledge and directions for further research are highlighted, particularly with regard to treatments for BED and ARFID, how to improve treatment engagement and the management of osteopenia.

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“…Interest in pharmacological approaches is starting to increase, as summarised in a recent review [129]. There is mixed evidence for the use of antipsychotic medications to treat AN [130], although a recent multicenter outpatient study of olanzapine found small positive effects on agitation and weight gain (albeit with no difference in rates of hospitalisation) [131]. The field may need to consider using drugs that have been shown to have benefit in OCD.…”

Section: Treatment-resistant Depression and Other Co-morbidities As Mmentioning

confidence: 99%

Cognitive Interpersonal Model for Anorexia Nervosa Revisited: The Perpetuating Factors that Contribute to the Development of the Severe and Enduring Illness

Treasure

Willmott

Ambwani

et al. 2020

JCM

132

122

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The cognitive interpersonal model was outlined initially in 2006 in a paper describing the valued and visible aspects of anorexia nervosa (Schmidt and Treasure, 2006). In 2013, we summarised many of the cognitive and emotional traits underpinning the model (Treasure and Schmidt, 2013). In this paper, we describe in more detail the perpetuating aspects of the model, which include the inter- and intrapersonal related consequences of isolation, depression, and chronic stress that accumulate in the severe and enduring stage of the illness. Since we developed the model, we have been using it to frame research and development at the Maudsley. We have developed and tested interventions for both patients and close others, refining the model through iterative cycles of model/intervention development in line with the Medical Research Council (MRC) framework for complex interventions. For example, we have defined the consequences of living with the illness on close others (including medical professionals) and characterised the intense emotional reactions and behaviours that follow. For the individual with an eating disorder, these counter-reactions can allow the eating disorder to become entrenched. In addition, the consequent chronic stress from starvation and social pain set in motion processes such as depression, neuroprogression, and neuroadaptation. Thus, anorexia nervosa develops a life of its own that is resistant to treatment. In this paper, we describe the underpinnings of the model and how this can be targeted into treatment.

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Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial

Cited by 135 publications

References 27 publications

Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial

Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial

Current approach to eating disorders: a clinical update

Cognitive Interpersonal Model for Anorexia Nervosa Revisited: The Perpetuating Factors that Contribute to the Development of the Severe and Enduring Illness

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