title: Atypical antipsychotics in severe anorexia nervosa in children and adolescents--review and case reports.
abstract: OBJECTIVE
  To review the literature on the use of atypical antipsychotics in anorexia nervosa of children and adolescents and to present three case reports on quetiapine treatment of this subgroup.
  
  
  METHODS
  Review of the literature and case report.
  
  
  RESULTS
  Several case reports and two small open-label trials, mainly in adults, observed beneficial effects of olanzapine on anorexic psychopathology. Only 16 case reports have been published on children and adolescents. Because of its lower propensity to induce weight gain quetiapine might be favourable with regard to patients' compliance. Our case reports revealed positive psychopathological effects and good tolerability of quetiapine in minors with severe anorexia nervosa. Careful titration and intense drug monitoring are recommended.
  
  
  CONCLUSIONS
  In a small subset of patients with severe, treatment- resistant anorexia nervosa, extreme weight phobia, delusional body image disturbances or severe hyperactivity might be considered as indications for atypical antipsychotics. However, controlled studies are needed.
authors.affiliation: Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5, Ulm, Germany. claudia.mehler-wex@uniklinik-ulm.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Mehler-Wex
authors.forename: Marcel
authors.initials: M
authors.lastname: Romanos
authors.forename: Julia
authors.initials: J
authors.lastname: Kirchheiner
authors.forename: Ulrike M E
authors.initials: UM
authors.lastname: Schulze
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000188:drug therapy* / Q000523:psychology; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D002648:Child; D003987:Dibenzothiazepines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077152:Olanzapine; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000627:therapeutic use
chemical_list: D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D018967:Risperidone; D000077152:Olanzapine