Adjunctive Use of Olanzapine in the Treatment of Avoidant Restrictive Food Intake Disorder in Children and Adolescents in an Eating Disorders Program.

Abstract

OBJECTIVE:

There is little information about the pharmacological treatment of avoidant and restrictive food intake disorder (ARFID), a challenging feeding disorder associated with marked impairment and developmental arrest. This brief clinical report seeks to fill this gap.

METHODS:

A retrospective chart review of nine patients with ARFID treated in an eating disorder (ED) program (residential, partial hospital, and intensive outpatient levels of care) with adjunctive olanzapine was undertaken.

RESULTS:

The mean initial and final olanzapine doses were 0.9 + 0.63 mg/day and 2.8 + 1.47 mg/day, respectively. There was a statistically significant difference in weight gain pre- versus post-olanzapine treatment (3.3 ± 7.3 lbs vs. 13.1 ± 7.9 lbs [2.99 ± 6.62 lb SI vs. 11.88 ± 7.17 lb SI], paired t-test (p < 0.04, t = -2.48). Clinically, adjunctive olanzapine was helpful for not only weight gain but also reduction of associated anxious, depressive, and cognitive symptoms. Clinical Global Impressions scale scores indicated marked improvement in patients receiving adjunctive olanzapine.

CONCLUSION:

These cases illustrate that judicious use of low-dose olanzapine, when used as an adjunct to other treatment modalities, may facilitate eating, weight gain, and the reduction of anxious, depressive, and cognitive symptoms in ARFID patients. Future randomized, placebo-controlled studies in ARFID are warranted.

• Authors: Timothy D Brewerton, Meredith D'Agostino
• Journal: Journal of child and adolescent psychopharmacology (J Child Adolesc Psychopharmacol) Vol. 27 Issue 10 Pg. 920-922 (Dec 2017) ISSN: 1557-8992 [Electronic] United States
• PMID: 29068721 (Publication Type: Journal Article)

Chemical References

• Antipsychotic Agents
• Benzodiazepines
• Olanzapine

Topics

• Adolescent
• Anorexia Nervosa (diagnosis, drug therapy, physiopathology)
• Antipsychotic Agents (administration & dosage)
• Appetite Regulation (drug effects, physiology)
• Benzodiazepines (administration & dosage)
• Child
• Combined Modality Therapy (methods)
• Feeding and Eating Disorders (diagnosis, drug therapy, physiopathology)
• Female
• Humans
• Male
• Olanzapine
• Retrospective Studies
• Weight Gain (drug effects, physiology)