Olanzapine therapy in anorexia nervosa: psychobiological effects.
Dopamine impairments occur in anorexia nervosa. The aim of this study was to see whether treatment with the atypical dopamine antagonist antipsychotic olanzapine improves the disorder. Thirty anorexics, 18 restricted and 12 bingeing-purging, underwent a 3-month course of cognitive behavioral therapy, plus at random and double-blinded oral olanzapine (2.5 mg for 1 month, 5 mg for 2 months) in half and oral placebo in the other half of them. BMI, psychopathological aspects (eating disorder inventory, Hamilton Rating Scale, Buss-Durkee Rating Scale, Yale Brown Cornell for Eating Disorders Rating Scale, temperament-character inventory), and homovanillic acid blood concentrations for dopamine secretion, were monitored at baseline and then monthly during the trial. At the end of the trial BMI, total eating disorder inventory, total Yale Brown Cornell for Eating Disorders Rating Scale, Buss-Durkee Rating Scale, Hamilton Rating Scale scores and in olanzapine-treated patients the subitems of eating disorder inventory ineffectiveness and maturity fear, of Buss-Durkee Rating Scale direct aggressiveness, of temperament-characteristic inventory persistence had improved significantly. When stratified for anorexia nervosa subtype, BMI changes were significant among anorexia nervosa bingeing-purging patient, 'depression' (Hamilton Rating Scale) and 'direct aggressiveness' (Buss-Durkee Rating Scale) among anorexia nervosa bingeing-purging patients, 'persistence' (temprerament-characteristic inventory), among anorexics restricted patients, with a trend toward significance for obsessivity-compulsivity (Yale Brown Cornell for Eating Disorders Rating Scale). homovanilic acid blood levels increased significantly in the cognitive behavioral therapy+olanzapine group. No correlations were observed between homovanilic acid concentrations and psychopathological parameters. The pharmacological treatment can significantly improve specific aspects of anorexia nervosa.
Brambilla
Francesca
F
Department Mental Health, Sacco Hospital, Milan, Italy. francesca.brambilla4@tin.it
Garcia
Cristina Segura
CS
Fassino
Secondo
S
Daga
Giovanni Abbate
GA
Favaro
Angela
A
Santonastaso
Paolo
P
Ramaciotti
Carla
C
Bondi
Emilia
E
Mellado
Carmen
C
Borriello
Renata
R
Monteleone
Palmiero
P
D000328:Adult; D000856:Anorexia Nervosa / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D018492:Dopamine Antagonists / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006719:Homovanillic Acid / Q000097:blood; D006801:Humans; D000077152:Olanzapine
D014150:Antipsychotic Agents; D018492:Dopamine Antagonists; D001569:Benzodiazepines; D000077152:Olanzapine; D006719:Homovanillic Acid