Atypical antipsychotics as augmentation therapy in anorexia nervosa

Area of Science:

• Psychiatry
• Clinical Psychology
• Pharmacology

Background:

• Anorexia nervosa (AN) is a severe psychiatric disorder with high mortality.
• Limited evidence exists for medication management in AN, particularly augmentation therapies.

Purpose of the Study:

• To investigate the real-world effectiveness of olanzapine and aripiprazole as augmentation agents for Selective Serotonin Reuptake Inhibitors (SSRIs) in adult inpatients with AN.
• To gather preliminary data on the impact of these augmentation strategies on eating symptomatology and psychopathology.

Main Methods:

• Retrospective evaluation of clinical charts of 75 adult inpatients with AN hospitalized between 2012 and 2014.
• Assessment of eating symptomatology and psychopathology using the Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale at admission and discharge.
• Comparison of outcomes between patients receiving SSRIs alone versus SSRIs with aripiprazole or olanzapine.

Main Results:

• All patient groups showed significant improvement in all measured psychopathological aspects upon discharge.
• Aripiprazole augmentation demonstrated a large effect size in reducing eating-related preoccupations and rituals.
• While both augmentation agents showed benefits, aripiprazole exhibited superior efficacy in targeting core eating disorder behaviors.

Conclusions:

• Augmentation therapy with aripiprazole, in addition to SSRIs, shows promising effectiveness in reducing eating-related obsessions and compulsions in adult AN inpatients.
• Further randomized controlled trials are necessary to validate these preliminary findings and establish aripiprazole as a viable treatment option for AN.