Brief Report
No access
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


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.

Get full access to this article

View all available purchase options and get full access to this article.


American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Press; 2013.
Brewerton TD: Antipsychotic agents in the treatment of anorexia nervosa: Neuropsychopharmacologic rationale and evidence from controlled trials. Curr Psychiatry Rep 14:398–405, 2012.
Bryant-Waugh R: Avoidant restrictive food intake disorder: An illustrative case example. Int J Eat Disord 46:420–423, 2013a.
Bryant-Waugh R: Feeding and eating disorders in children. Curr Opin Psychiatry 26:537–542, 2013b.
Fisher MM, Rosen DS, Ornstein RM, Mammel KA, Katzman DK, Rome ES, Callahan ST, Malizio J, Kearney S, Walsh BT: Characteristics of avoidant/restrictive food intake disorder in children and adolescents: A “new disorder” in DSM-5. J Adolesc Health 55:49–52, 2014.
Guy W: The Clinical Global Impression Scale. In: ECDEU Assessment Manual for Psychopharmacology-Revised. Rockville, MD: US Dept. of Health, Education and Welfare, ADAMHA, MIMH Psychopharmacology Research Branch, 1976, pp. 218–222.
Kreipe RE, Palomaki A: Beyond picky eating: Avoidant/restrictive food intake disorder. Curr Psychiatry Rep 14:421–431, 2012.
Nicely TA, Lane-Loney S, Masciulli E, Hollenbeak CS, Ornstein RM: Prevalence and characteristics of avoidant/restrictive food intake disorder in a cohort of young patients in day treatment for eating disorders. J Eat Disord 2:21, 2014.
Norris ML, Katzman DK: Change is never easy, but it is possible: Reflections on avoidant/restrictive food intake disorder two years after its introduction in the DSM-5. J Adolesc Health 57:8–9, 2015.
Norris ML, Robinson A, Obeid N, Harrison M, Spettigue W, Henderson K: Exploring avoidant/restrictive food intake disorder in eating disordered patients: A descriptive study. Int J Eat Disord 47:495–499, 2014.
Norris ML, Spettigue W, Buchholz A, Henderson KA, Gomez R, Maras D, Gaboury I, Ni A: Olanzapine use for the adjunctive treatment of adolescents with anorexia nervosa. J Child Adolesc Psychopharmacol 21:213–220, 2011.
Ornstein RM, Rosen DS, Mammel KA, Callahan ST, Forman S, Jay MS, Fisher M, Rome E, Walsh BT: Distribution of eating disorders in children and adolescents using the proposed DSM-5 criteria for feeding and eating disorders. J Adolesc Health 53:303–305, 2013.
Swenne I, Rosling A: No unexpected adverse events and biochemical side effects of olanzapine as adjunct treatment in adolescent girls with eating disorders. J Child Adolesc Psychopharmacol 21:221–227, 2011.

Information & Authors


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


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


Request permissions for this article.




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.


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


The authors have no conflicts of interest to declare.

Metrics & Citations



Export citation

Select the format you want to export the citations of this publication.

View Options

Get Access

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options


View PDF/ePub

Full Text

View Full Text







Copy the content Link

Share on social media

Back to Top