Low-Dose Olanzapine Monotherapy in Girls with Anorexia Nervosa, Restricting Subtype: Focus on Hyperactivity

Leggero, Chiara; Masi, Gabriele; Brunori, Elena; Calderoni, Sara; Carissimo, Renato; Maestro, Sandra; Muratori, Filippo

doi:10.1089/cap.2009.0072

Cited by 44 publications

(37 citation statements)

References 27 publications

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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).…”

Section: Introductionmentioning

confidence: 99%

Olanzapine, but Not Fluoxetine, Treatment Increases Survival in Activity-Based Anorexia in Mice

Klenotich

Seiglie

McMurray

et al. 2012

Neuropsychopharmacol

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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.

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Section: Introductionmentioning

confidence: 99%

Olanzapine, but Not Fluoxetine, Treatment Increases Survival in Activity-Based Anorexia in Mice

Klenotich

Seiglie

McMurray

et al. 2012

Neuropsychopharmacol

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“…It should be always assessed and taken into account, mainly with outpatients. Moreover, an open label trial demonstrated a role for olanzapine in reducing hyperactivity in AN adolescents, mediating weight recovery (Leggero et al 2010). Third, according to the CGAS, all our patients had a high level of functional impairment, with relevant limitations in several areas of functioning.…”

Section: Discussion and Hypothesismentioning

confidence: 72%

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

Pisano

Catone

Pascotto

et al. 2014

Journal of Child and Adolescent Psychopharmacology

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“…One small case series of hospitalized adolescents with AN noted increases in rate of weight gain and a reduction in agitation and anxiety, particularly at meal times [73], while another small case series found that preoccupation with body image and anxiety relating to weight decreased but that there was no difference in rate of weight gain before versus after administration of the drug [74]. A small study of adolescents treated with olanzapine for 6 months showed significant increases in BMI after one month of treatment, with continued weight gain throughout the study and improvements in eating attitudes, global functioning scores, anxiety, hyperactivity, and depression [75]. Although the results of these studies are encouraging, none of them were RCTs; the first doubleblinded RCT of olanzapine in female adolescents has been suspended due to difficulties in recruitment [76].…”

Section: Psychiatric Complications and Treatmentsmentioning

confidence: 99%

A Review of the Role of Psychiatrists and Pediatricians in Outpatient Treatment of Adolescents with Anorexia and Bulimia Nervosa

Stiles‐Shields¹,

Smyth²,

Glunz³

et al. 2011

CPSR

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Eating disorders frequently have their onset in adolescence. This is problematic as Anorexia Nervosa (AN), Bulimia Nervosa (BN), and Eating Disorder Not Otherwise Specified (EDNOS) often present with serious psychiatric and medical sequelae that can affect an adolescent's physical and emotional development. It is well documented that complications from eating disorders in adolescence can result in long-term health consequences, rendering effective psychiatric and medical treatments a necessity. To combat the medical consequences associated with eating disorders in adolescents, pediatricians must identify, treat, and monitor medical complications. Pediatricians are also responsible for assessing the need for hospitalization due to medical instability. Some advances have been made regarding psychopharmacological treatments for eating disorders. For example, antidepressant medications, such as SSRIs, have demonstrated efficacy in the treatment of adults with BN. The true effectiveness of these medications in adolescent populations remains unknown. A multidisciplinary team approach is a common treatment model in outpatient practice, but further research is required to investigate how to facilitate the collaboration of psychiatric and medical professionals. The majority of psychiatric and medical trials for eating disorder patients have involved adult participants, and most studies have investigated either psychiatric or medical treatments for eating disorders. In this review, we will add to the current literature by focusing on both psychiatric and medical treatments for eating disorders, with particular emphasis on studies conducted with adolescents.

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Low-Dose Olanzapine Monotherapy in Girls with Anorexia Nervosa, Restricting Subtype: Focus on Hyperactivity

Abstract: Low-dose olanzapine monotherapy may be useful as adjunctive treatment of youths with ANr. It is suggested that efficacy may be mediated by a decrease of hyperactivity.

Cited by 44 publications

References 27 publications

Olanzapine, but Not Fluoxetine, Treatment Increases Survival in Activity-Based Anorexia in Mice

Olanzapine, but Not Fluoxetine, Treatment Increases Survival in Activity-Based Anorexia in Mice

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

A Review of the Role of Psychiatrists and Pediatricians in Outpatient Treatment of Adolescents with Anorexia and Bulimia Nervosa

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