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DRUG INFORMATION ROUNDS

The Role of Olanzapine in the Treatment of Anorexia Nervosa

at time of writing, Instructor of Pharmacy Practice, School of Pharmacy–Worcester, Massachusetts College of Pharmacy and Health Sciences, Worcester, MA; now, Assistant Professor of Pharmacy Practice, School of Pharmacy–Worcester, Massachusetts College of Pharmacy and Health Sciences

Dana DelDotto, PharmD

at time of writing, PharmD Student, School of Pharmacy–Worcester, Massachusetts College of Pharmacy and Health Sciences; now, Pharmacy Practice Resident, Veterans Affairs Medical Center, Providence, RI

Reprints: Dr. Dunican, School of Pharmacy–Worcester, Massachusetts College of Pharmacy and Health Sciences, 19 Foster St., Worcester, MA 01608, fax 508/756-8715, Kaelen.Dunican{at}wor.mcphs.edu

OBJECTIVE: To evaluate the role of olanzapine in the treatment of anorexia nervosa.

DATA SOURCES: Literature was obtained through searches of MEDLINE (1966–December 2006), EMBASE (1980–4th Quarter 2006), and PsycINFO (1985–December 2006) and a bibliographic review of published articles. Key terms used in the searches included anorexia nervosa, antipsychotics, eating disorders, olanzapine, and Zyprexa.

STUDY SELECTION AND DATA EXTRACTION: All English language articles that were identified from the search were evaluated. All primary literature was included in the review.

DATA SYNTHESIS: In several case reports and most clinical trials, patients with anorexia nervosa successfully gained weight while being treated with olanzapine. Moreover, many patients treated with olanzapine achieved a healthy body weight. Case reports and trials identified additional benefits of olanzapine, including reduction in delusional thinking; improvement in body image, sleep, depressive symptoms, adherence to treatment, and eating-disorder symptoms; and decreased agitation and premeal anxiety.

CONCLUSIONS: Preliminary evidence supports the use of olanzapine for treatment of anorexia nervosa by demonstrating that olanzapine 2.5–15 mg daily promotes weight gain and has positive effects on associated psychological symptoms. Limitations of the reported data include small sample size, low completion rate in clinical trials, and open-label trial design. Although olanzapine appears to have a potential role in the treatment of anorexia nervosa that has been unresponsive to other therapy, randomized, placebo-controlled studies with larger sample sizes are necessary to establish its role in therapy.

Key Words: anorexia nervosa, atypical antipsychotics, eating disorders, olanzapine

Published Online, December 26, 2006. www.theannals.com, DOI 10.1345/aph.1H297

This article has been cited by other articles:

				H. Bissada, G. A. Tasca, A. M. Barber, and J. Bradwejn Olanzapine in the Treatment of Low Body Weight and Obsessive Thinking in Women With Anorexia Nervosa: A Randomized, Double-Blind, Placebo-Controlled Trial Am J Psychiatry, October 1, 2008; 165(10): 1281 - 1288. [Abstract] [Full Text] [PDF]