Olanzapine in the Treatment of Low Body Weight and Obsessive Thinking in Women With Anorexia Nervosa: A Randomized, Double-Blind, Placebo-Controlled Trial (2008)

I was interested in this article as one of the patients I evaluated during the psychiatry rotation was a patient with a 30 year history of anorexia nervosa, who continues to struggle with her disorder. The purpose of this article was to assess the efficacy of Olanzapine in promoting weight gain in young women with anorexia nervosa as well as to evaluate the anti-obsessive, anti-compulsive, anti-anxiety and anti-depressant properties of the medication. This was a double-blind placebo-controlled 10-week flexible dose trial where patients with anorexia nervosa were randomly assigned to either Olanzapine and hospital treatment or placebo and hospital treatment. Participants were recruited from patients referred to the eating disorder program at The Ottawa Hospital. The study found that compared with placebo Olanzapine resulted in greater increase in weight, earlier achievement of target BMI, and greater rate of decrease in obsessive symptoms. No difference in adverse effects observed between the two treatment conditions. Treatment adherence monitored through weekly urine samples.

Olanzapine has been reported to be clinically beneficial in anorexia nervosa in terms of facilitating weight gain and reducing the obsessive pursuit of thinness and associated anxiety observed in these patients. LK is a patient with major depressive disorder, borderline personality disorder, and a 30 year history of anorexia. Although she is 53 and not a young female as assessed in the study, Olanzapine may be beneficial to LK as she has only been treated for anorexia through therapy and never medications. The patient has participated in sporadic treatment and changes her mind very often in regard to both understanding her conditions and seeking treatment for them. Changing her anorexia treatment from therapy to medication could give her a different option after 30 years of failure with therapy and may help her gain weight, as well as not be as obsessive about her body image as she has been thus far.