IRCCS Istituto delle Scienze Neurologiche di Bologna, Regional Center for Feeding and Eating Disorders in Children and Adolescents, Child Neurology and Psychiatry Unit, Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
J Child Adolesc Psychopharmacol. 2022 Jun;32(5):304-310. doi: 10.1089/cap.2022.0003. Epub 2022 May 24.
Although recent articles have investigated the use of low-dose olanzapine in different psychiatric conditions, only one study so far has assessed this treatment in 13 girls with anorexia nervosa (AN). Observational naturalistic case-control study aimed at reporting the use and tolerability of low-dose olanzapine in the context of a multidisciplinary hospital intervention for adolescents with AN. Three groups with AN were compared: group 1 was treated with low-dose olanzapine (≤5 mg/day), group 2 with full-dose olanzapine (>5 mg/day), and group 3 (control group) was treated without antipsychotics. Psychopathology was assessed at admission (T0) and discharge (T1) with Eating Disorders Inventory-3 Eating Disorders Risk, Body Uneasiness Test Global Severity Index (BUT-GSI), Beck's Depression Inventory-II (BDI-II), and Self-administered Psychiatric Scales for Children and Adolescents, Depression subtest (SAFA-D). Possible differences among the three groups, concerning clinical and treatment variables, were screened. Then, potential differences of T0-T1 modifications in psychopathological variables among the three treatment groups were assessed with analyses of covariance, corrected for baseline psychopathology and potential confounders, including possible concurrent antidepressants. A total of 118 patients were enrolled ( = 94.1%; mean age = 15.4 ± 1.7 years), including 52 controls, 37 treated with low-dose olanzapine, and 29 with full-dose olanzapine. Low-dose olanzapine was well tolerated and used for a mean of 132.1 (±98.6) days, starting with a dosage of 3.4 (±1.2) mg/day and increasing to a maximum dose of 4.4 (±1.1) mg/day. The multidisciplinary intervention resulted in an improvement of BUT-GSI ( < 0.001), BDI-II ( < 0.001), and SAFA-D ( < 0.001) for the entire sample. Individuals treated with full-dose olanzapine experienced a significantly lower improvement in depressive measures: BDI-II ([2,61] = 12.653, < 0.001, η = 0.269) and SAFA-D ([2,57] = 7.413, = 0.001, η = 0.170), than the other groups. This naturalistic controlled study expands the existing evidence on the use and tolerability of low-dose olanzapine in adolescents with AN. These results should be assessed in wider and prospective samples.
虽然最近有一些文章研究了低剂量奥氮平在不同精神科疾病中的应用，但迄今为止，只有一项研究评估了低剂量奥氮平在 13 名神经性厌食症（AN）女孩中的治疗效果。本观察性自然病例对照研究旨在报告在针对 AN 青少年的多学科医院干预背景下使用和耐受低剂量奥氮平的情况。比较了三组 AN 患者：组 1 接受低剂量奥氮平（≤5mg/天）治疗，组 2 接受全剂量奥氮平（>5mg/天）治疗，组 3（对照组）未接受抗精神病药物治疗。采用饮食障碍问卷-3 饮食障碍风险、身体不适测试全球严重程度指数（BUT-GSI）、贝克抑郁量表第二版（BDI-II）和儿童青少年自我管理精神病量表，在入院（T0）和出院（T1）时评估精神病理学。筛选了三组之间与临床和治疗变量有关的可能差异。然后，采用协方差分析评估了三组治疗组中 T0-T1 期间精神病理变量变化的潜在差异，结果校正了基线精神病理学和潜在混杂因素，包括可能同时使用的抗抑郁药。共纳入 118 例患者（ = 94.1%；平均年龄 15.4 ± 1.7 岁），包括 52 例对照组、37 例低剂量奥氮平治疗组和 29 例全剂量奥氮平治疗组。低剂量奥氮平耐受性良好，平均使用 132.1（±98.6）天，起始剂量为 3.4（±1.2）mg/天，最大剂量为 4.4（±1.1）mg/天。多学科干预使 BUT-GSI（ < 0.001）、BDI-II（ < 0.001）和 SAFA-D（ < 0.001）均得到改善。全剂量奥氮平治疗组的抑郁测量值改善明显较低：BDI-II ([2,61] = 12.653, < 0.001, η = 0.269) 和 SAFA-D ([2,57] = 7.413, = 0.001, η = 0.170)。这项自然对照研究扩大了低剂量奥氮平在青少年 AN 中的应用和耐受性的现有证据。这些结果应在更广泛和前瞻性的样本中进行评估。
