Second Generation Antipsychotics in Adolescent Anorexia Nervosa: A New Hypothesis of Eligibility Criteria

Pisano, Simone; Catone, Gennaro; Pascotto, Antonio; Gritti, Antonella

doi:10.1089/cap.2013.0124

Cited by 12 publications

(5 citation statements)

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“…Biochemical side effects were closely monitored and were felt to be more related to refeeding processes than to medication [141]. Thirteen case reports (Table 24) have also been published [42,[143][144][145][146][147][148][149][150][151][152][153][154]. Pisano and colleagues [143] reported on five cases of adolescents with AN treated with 2.5 to 7.5 mg of olanzapine.…”

Section: Olanzapinementioning

confidence: 99%

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

et al. 2020

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Objectives: Eating disorders are common and serious conditions affecting up to 4% of the population. The mortality rate is high. Despite the seriousness and prevalence of eating disorders in children and adolescents, no Canadian practice guidelines exist to facilitate treatment decisions. This leaves clinicians without any guidance as to which treatment they should use. Our objective was to produce such a guideline. Methods: Using systematic review, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, and the assembly of a panel of diverse stakeholders from across the country, we developed high quality treatment guidelines that are focused on interventions for children and adolescents with eating disorders. Results: Strong recommendations were supported specifically in favour of Family-Based Treatment, and more generally in terms of least intensive treatment environment. Weak recommendations in favour of Multi-Family Therapy, Cognitive Behavioural Therapy, Adolescent Focused Psychotherapy, adjunctive Yoga and atypical antipsychotics were confirmed. Conclusions: Several gaps for future work were identified including enhanced research efforts on new primary and adjunctive treatments in order to address severe eating disorders and complex co-morbidities.

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Section: Olanzapinementioning

confidence: 99%

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

et al. 2020

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“…• Only one case report did not observe weight gain [42], while the others (La Via [43], Jensen [44], Boachie [45], Ercan [46], and Pisano [47]) all reported that the patients gained weight.…”

Section: Plos Onementioning

confidence: 94%

“…Overall, these different case reports from pediatric and adult populations have principally emphasized weight gain and a reduction in anorexic cognitions and mixed anxiety and depression symptoms. Some authors [47] have proposed eligibility criteria for a prescription of olanzapine: for patients with no response at the end of a month of psychotherapy, food intake less than 800 kcal/d, associated mood disorders that are clinically severe, with major functional repercussions and massive denial.…”

Section: Plos Onementioning

confidence: 99%

Efficacy and tolerance of second-generation antipsychotics in anorexia nervosa: A systematic scoping review

et al. 2023

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Introduction Second-generation antipsychotics (SGAs) are frequently prescribed for the treatment of resistant anorexia nervosa. However, few clinical trials have been conducted so far and no pharmacological treatment has yet been approved by the Food and Drug Administration. The aim of this paper is to conduct a systematic scoping review exploring the effectiveness and safety of atypical antipsychotics in anorexia nervosa (AN). Method We conducted a systematic scoping review of the effectiveness and tolerability of SGAs in the management of AN. We included articles published from January 1, 2000, through September 12, 2022 from the PubMed and PsycInfo databases and a complementary manual search. We selected articles about adolescents and adults treated for AN by four SGAs (risperidone, quetiapine, aripiprazole or olanzapine). This work complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRIMA-ScR) and was registered in the Open Science Framework (OSF) repository. Results This review included 55 articles: 48 assessing the effectiveness of SGAs in AN and 7 focusing only on their tolerability and safety. Olanzapine is the treatment most frequently prescribed and studied with 7 randomized double-blind controlled trials. Other atypical antipsychotics have been evaluated much less often, such as aripiprazole (no randomized trials), quetiapine (two randomized controlled trials), and risperidone (one randomized controlled trial). These treatments are well tolerated with mild and transient adverse effects in this population at particular somatic risk. Discussion Limitations prevent the studies both from reaching conclusive, reliable, robust, and reproducible results and from concluding whether or not SGAs are effective in anorexia nervosa. Nonetheless, they continue to be regularly prescribed in clinical practice. International guidelines suggest that olanzapine and aripiprazole can be interesting in severe or first-line resistant clinical situations.

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“…First of all, the association between EDs, AN and schizophrenia and/or psychotic symptoms; secondly, the use of antipsychotics in the multilevel treatment of AN. For the last aspect there are scattered naturalistic and open label contributions and more recently randomized controlled trial on the use of this speci c pharmaceutical class for several AN symptoms or disease condition (6)(7)(8)(9)(10). On the other hand, looking at the AN psychosis association, the contributions appear to be poorly systematized and mainly related to case reports or adult studies (5,(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Association Between Paranoia And Anorexia Nervosa In Adolescents: What Factors Are Involved? 

Catone

Salerno

Muzzo

et al. 2020

Preprint

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Background: psychiatric comorbidities are of particular interest in Eating disorders. The association between anorexia nervosa and psychotic disorders is less studied than that with affective disorders (anxiety/depression). The aim of this study is to describe a psychotic symptom (paranoia) in adolescents with Eating Disorders looking at several potential explicative associated factors: eating disorder symptoms, body image concerns, depression and social anxiety. Our hypothesis is that paranoia in AN patients is more explained by the concomitant depression and social anxiety symptoms than core symptoms of the disease (eating disorder symptoms or body image concerns). Methods: this is a retrospective cross sectional study and consecutive, help-seeking adolescents admitted to the Eating Disorder service of the Integrated Pediatric Care Department, Luigi Vanvitelli University Hospital constituted the sample. Data was obtained trough retrospective collection of clinical interviews and self – report questionnaires administered by trained and expert child and adolescent psychiatrists. Results: We obtained data from 92 adolescents with Eating Disorders. Paranoia was dimensionally distributed in the sample (mean: 22,17 SD: 17,7; median 18 IQR: 7/36; range: 0-62). Our regression model explained that paranoia in this population was better explained by depression (coefficient= 0,415 SD: 0,210, p=0,052) and social anxiety symptoms (coefficient= 0,253 SD: 0,060; p<0,001) than eating disorder symptoms (coefficient= 0,092 SD: 0,107; p=0,398) and body image concerns (coefficient= 1,916 SD: 2,079; p=0,359) that did not retain their significance when all our predictive factors entered in the model. Conclusion: This study has some theoretical, clinical and treatment implications. It is important to carrying out screening for the presence of psychotic symptoms in patients with Eating Disorders. These symptoms and associated factors (depression and social anxiety) may complicate the clinical picture of the disease with the need, in certain cases, of psychopharmacological drugs and, among these, anti-psychotics. Finally in the psychotherapy context, paranoid idea may be subject of treatment for patient with EDs.

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Second Generation Antipsychotics in Adolescent Anorexia Nervosa: A New Hypothesis of Eligibility Criteria

Cited by 12 publications

References 13 publications

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Efficacy and tolerance of second-generation antipsychotics in anorexia nervosa: A systematic scoping review

Association Between Paranoia And Anorexia Nervosa In Adolescents: What Factors Are Involved?

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Second Generation Antipsychotics in Adolescent Anorexia Nervosa: A New Hypothesis of Eligibility Criteria

Cited by 12 publications

References 13 publications

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Canadian practice guidelines for the treatment of children and adolescents with eating disorders

Efficacy and tolerance of second-generation antipsychotics in anorexia nervosa: A systematic scoping review

Association Between Paranoia And Anorexia Nervosa In Adolescents: What Factors Are Involved?&nbsp;

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Association Between Paranoia And Anorexia Nervosa In Adolescents: What Factors Are Involved?