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Published Online: 1 December 2017

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

Publication: Journal of Child and Adolescent Psychopharmacology
Volume 27, Issue Number 10

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.

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References

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Published In

cover image Journal of Child and Adolescent Psychopharmacology
Journal of Child and Adolescent Psychopharmacology
Volume 27Issue Number 10December 2017
Pages: 920 - 922
PubMed: 29068721

History

Published in print: December 2017
Published online: 1 December 2017
Published ahead of print: 25 October 2017

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Timothy D. Brewerton
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina.
Meredith D'Agostino
Department of Nursing, University of South Carolina, Columbia, South Carolina.

Notes

Address correspondence to:Timothy D. Brewerton, MD216 Scott StreetMt. Pleasant, SC 29464E-mail: [email protected]

Disclosures

The authors have no conflicts of interest to declare.

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