Olanzapine Versus Placebo in Adult Outpatients With Anorexia Nervosa: A Randomized Clinical Trial

被引:103
作者
Attia, Evelyn [1 ,3 ,4 ]
Steinglass, Joanna E. [1 ,3 ]
Walsh, B. Timothy [1 ,3 ]
Wang, Yuanjia [1 ,2 ]
Wu, Peng [2 ]
Schreyer, Colleen [5 ]
Wildes, Jennifer [6 ,7 ]
Yilmaz, Zeynep [8 ]
Guarda, Angela S. [5 ]
Kaplan, Allan S. [9 ,10 ]
Marcus, Marsha D. [6 ]
机构
[1] Columbia Univ, Dept Psychiat, Irving Med Ctr, New York, NY 10027 USA
[2] Columbia Univ, Mailman Sch Publ Hlth, Dept Biostat, New York, NY USA
[3] New York State Psychiat Inst & Hosp, Eating Disorders Res Program, New York, NY 10032 USA
[4] Weill Cornell Med Coll, Ctr Eating Disorders, New York, NY 10065 USA
[5] Johns Hopkins Med, Dept Psychiat & Behav Sci, Baltimore, MD USA
[6] Univ Pittsburgh, Dept Psychiat, Med Ctr, Pittsburgh, PA USA
[7] Univ Chicago, Dept Psychiat & Behav Neurosci, Chicago, IL 60637 USA
[8] Univ N Carolina, Ctr Excellence Eating Disorders, Chapel Hill, NC 27515 USA
[9] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
[10] Univ Toronto, Toronto Ctr Addict & Mental Hlth, Toronto, ON, Canada
关键词
OBSESSIVE-COMPULSIVE SCALE; SHORT-TERM TREATMENT; DOUBLE-BLIND; EATING-DISORDERS; THERAPY; ADOLESCENTS; FLUOXETINE; WEIGHT;
D O I
10.1176/appi.ajp.2018.18101125
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: This study evaluated the benefits of olanzapine compared with placebo for adult outpatients with anorexia nervosa. Methods: This randomized double-blind placebo-controlled trial of adult outpatients with anorexia nervosa (N= 152, 96% of whom were women; the sample's mean body mass index [BMI] was 16.7) was conducted at five sites in North America. Participants were randomly assigned in a 1: 1 ratio to receive olanzapine or placebo and were seen weekly for 16 weeks. The primary outcome measures were rate of change in body weight and rate of change in obsessionality, assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS). Results: Seventy-five participants were assigned to receive olanzapine and 77 to receive placebo. A statistically significant treatment-by-time interaction was observed, indicating that the increase in BMI over time was greater in the olanzapine group (0.259 [SD= 0.051] compared with 0.095 [SD= 0.053] per month). There was no significant difference between treatment groups in change in the YBOCS obsessions subscale score over time (20.325 compared with 20.017 points per month) and there were no significant differences between groups in the frequency of abnormalities on blood tests assessing potential metabolic disturbances. Conclusions: This study documented a modest therapeutic effect of olanzapine compared with placebo on weight in adult outpatients with anorexia nervosa, but no significant benefit for psychological symptoms. Nevertheless, the finding on weight is notable, as achieving change in weight is notoriously challenging in this disorder.
引用
收藏
页码:449 / 456
页数:8
相关论文
共 28 条
[1]  
[Anonymous], 2000, Diagnostic and Statistical Manual of Mental Disorders, DOI 10.1176/dsm10.1176/appi.books.9780890420249.dsm-iv-tr
[2]   Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders A Meta-analysis of 36 Studies [J].
Arcelus, Jon ;
Mitchell, Alex J. ;
Wales, Jackie ;
Nielsen, Soren .
ARCHIVES OF GENERAL PSYCHIATRY, 2011, 68 (07) :724-731
[3]   Olanzapine versus placebo for out-patients with anorexia nervosa [J].
Attia, E. ;
Kaplan, A. S. ;
Walsh, B. T. ;
Gershkovich, M. ;
Yilmaz, Z. ;
Musante, D. ;
Wang, Y. .
PSYCHOLOGICAL MEDICINE, 2011, 41 (10) :2177-2182
[4]   Does fluoxetine augment the inpatient treatment of anorexia nervosa? [J].
Attia, E ;
Haiman, C ;
Walsh, T ;
Flater, SR .
AMERICAN JOURNAL OF PSYCHIATRY, 1998, 155 (04) :548-551
[5]   Olanzapine in the treatment of low body weight and obsessive thinking in women with anorexia nervosa: A randomized, double-blind, placebo-controlled trial [J].
Bissada, Hany ;
Tasca, Giorgio A. ;
Barber, Ann Marie ;
Bradwejn, Jacques .
AMERICAN JOURNAL OF PSYCHIATRY, 2008, 165 (10) :1281-1288
[6]   Olanzapine therapy in anorexia nervosa: psychobiological effects [J].
Brambilla, Francesca ;
Garcia, Cristina Segura ;
Fassino, Secondo ;
Daga, Giovanni Abbate ;
Favaro, Angela ;
Santonastaso, Paolo ;
Ramaciotti, Carla ;
Bondi, Emilia ;
Mellado, Carmen ;
Borriello, Renata ;
Monteleone, Palmiero .
INTERNATIONAL CLINICAL PSYCHOPHARMACOLOGY, 2007, 22 (04) :197-204
[7]   A NEW TREATMENT OF ANOREXIA NERVOSA [J].
DALLY, PJ ;
SARGANT, W .
BMJ-BRITISH MEDICAL JOURNAL, 1960, 1 (JUN11) :1770-1773
[8]   Second-Generation Antipsychotic Drugs in Anorexia Nervosa: A Meta-Analysis of Randomized Controlled Trials [J].
Dold, Markus ;
Aigner, Martin ;
Klabunde, Megan ;
Treasure, Janet ;
Kasper, Siegfried .
PSYCHOTHERAPY AND PSYCHOSOMATICS, 2015, 84 (02) :110-116
[9]  
DSM-5, 2013, DIAGNOSTIC STAT MANU, DOI DOI 10.1176/APPI.BOOKS.9780890425596
[10]  
Fairburn Christopher G., 1993, P317