Lived experiences of adolescents with anorexia nervosa and their parents during olanzapine treatment: a qualitative study.

Abstract

Background: Olanzapine is commonly prescribed in Anorexia Nervosa, despite conflicting evidence regarding its efficacy and safety. This study aimed to complement existent quantitative by exploring the lived experiences of adolescents and parents with this treatment.

Method: Ten adolescent girls and ten parents were interviewed in a single psychiatric department in Paris. Data saturation was achieved. We used semi-structured interviews enriched with narrative methods, including writing tasks and picture elicitation questions.

Results: Four chronological meta-themes were identified: (1) Introduction of antipsychotic treatment with Olanzapine: rapid acceptance generating mixed feelings about the future. (2) The first few weeks of medication: Adolescents questioning alone the treatment after first intakes. (3) Taking note of the results during the initial few months of treatment. (4) Then what? Fears and doubts about the future.

Conclusion: The prescription of olanzapine was often perceived as a liminal stage-a transitional moment akin to a "rite of passage" in the trajectory of Anorexia Nervosa. For many adolescents, it represented an opportunity to assert autonomy and gain a sense of empowerment in their relationships with both the medical team and their parents. However, implicit concerns about weight gain as a side effect often became a core issue of miscommunication. These concerns should be openly addressed throughout the treatment process. Shortening the usual duration of olanzapine therapy may offer a constructive path toward reinforcing the therapeutic alliance and avoiding non-medical discontinuation.