Evaluation of Drug Treatment for AN (Olanzapine and SSRIs)

Question 1

+ Jensen (Antipsychotics)

Answer 1

Jensen used olanzapine in 3 cases suffering with AN. All patients restored their body weight and appetite as well as their self-image. They now think of themselves as normal, functioning adults

Question 2

+ Bissida (Antipsychotics)

Answer 2

Bassida found that compared to a placebo, olanzapine resulted in a greater rate of increase in weight, earlier achievement of target BMI, and a greater rate of decrease in obsessive symptoms

Question 3

• Convincing patients to start olanzapine treatment (Antipsychotics)

Answer 3

It is hard to convince the patient to start and to continue with olanzapine therapy within the first 2 months because it takes a few weeks before a full antipsychotic effect is achieved

Question 4

+/- Kaye (SSRIs - antidepressants)

Answer 4

Kaye found that SSRIs are not useful when AN subjects are malnourished and underweight; however, when given after weight restoration, fluoxetine may significantly reduce the extremely high rate of relapse normally seen in AN

Question 5

• Myung (SSRIs - antidepressants)

Answer 5

Myung examined feeding behaviour in rats after two weeks of administering fluoxetine (an SSRI) daily. Fluoxetine persistently suppressed food intake and weight gain during the experimental period. In conclusion, fluoxetine led to a substantial reduction in food intake - SSRIs could add to anorexia (- however, research on rats cannot be generalised to humans)

Question 6

• Holtkamp (SSRIs - antidepressants)

Answer 6

Holtkamp et al. compared 32 AN adolescents of which 19 received SSRI treatment while the other 13 were non-medicated. Rates of hospital readmission were similar in both groups and no significant difference was found in scores of eating disorder symptoms, obsessive compulsive traits, and depression

Question 7

• Symptoms not causes (both)

Answer 7

Drugs focus on the symptoms and not the cause of AN and the benefits may be reversed if the patient stops taking the drug - drug treatments do not treat the social aspect, only biological causes

Question 8

+/- Drugs to treat symptoms (both)

Answer 8

Despite the lack of FDA (US Food and Drug Administration) approved medications for anorexia nervosa, the prescribing clinician can assess and treat comorbid conditions knowing that this will help improve quality of life and hopefully make recovery from the eating disorder more successful, even if the drugs don’t directly improve weight gain - supports use of drugs as they can treat aspects of the condition (- however, more research is required to develop AN-specific treatments)