Efficacy of Adjunct Olanzapine Treatment in Adolescents With Anorexia Nervosa: A Comparison of Two Patient Cohorts.

Background: Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality, requiring innovative treatment strategies. Olanzapine (OLZ), an atypical antipsychotic, has demonstrated efficacy in promoting weight gain and reducing psychopathological symptoms in adults with AN. However, its efficacy and safety in adolescents remain insufficiently explored.

Objective: This study assessed the impact of adjunctive OLZ in adolescents with AN during inpatient care, focussing on weight gain, eating disorder pathology, and metabolic safety.

Methods: A naturalistic, prospective study compared two groups of adolescent inpatients with AN (n = 47 each), one receiving standard multidisciplinary care plus OLZ and one receiving standard care alone (Non-OLZ). Weekly weight gain as well as admission-to-discharge changes in body-mass-index, eating disorder symptoms, and metabolic markers were compared between the two cohorts.

Results: The OLZ group (∅ 9 mg/day) achieved greater weekly weight gain (0.898 vs. 0.677 kg, p = 0.004) compared to the Non-OLZ group. Both groups showed similar reductions in eating disorder pathology; however, improvements in body dissatisfaction were larger in the Non-OLZ group. Administration of OLZ was associated with significant prolactin level increases.

Conclusions: OLZ is a promising adjunctive treatment for adolescents in terms of supporting weight gain during inpatient care. However, psychological effects and possible metabolic risks warrant further study.