Mosheva Mariela, Sela Yaron, Arad-Rubinshtein Shani, Serur Yaffa, Omer Ganit, Hertz-Palmor Nimrod, Gothelf Doron, Stein Daniel
Child Psychiatry Division, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, 5262000, Israel.
The Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Eur Child Adolesc Psychiatry. 2025 Apr 24. doi: 10.1007/s00787-025-02713-w.
Avoidant restrictive food intake disorder (ARFID) is a childhood feeding and eating disorder often associated with marked physical and psychosocial impairment.
We assessed the use of atypical antipsychotic (AAP) medications (mostly risperidone) in promoting weight and height gain in children with ARFID.
The computerized medical records of 21 children with ARFID receiving AAPs in one center in Israel were retrospectively reviewed. Fourteen children received AAPs after 6.30 ± 0.75 months of no weight gain with treatment as usual (either group or individual cognitive behavioral therapy); seven children were admitted to our clinic receiving AAPs in previous facilities because of lack of weight gain. All were followed-up for 18 months. Weight and height were extracted from the medial records at eight time points.
A significant increase was found in weight, height, and body mass index (BMI) over 18 months of treatment with AAPs (Δweight: 9.66 ± 9.24 kg, p < 0.001; Δheight: 10.23 ± 11.54 cm, p < 0.001; ΔBMI = 2.55 ± 1.53 kg/m; p < 0.001). Weight increased significantly for both sexes, while height increased significantly only for boys. Patients with both low and high baseline BMI percentiles gained weight, while mean height increased significantly over time only for children with low BMI percentile. The use of a retrospective clinical global impression scale indicated a marked improvement over time. Adverse effects were minimal, and no patients discontinued AAPs due to adverse events.
The addition of AAPs for a period of 18 months may be safe and effective in increasing weight and height in children with ARFID.
回避性限制性食物摄入障碍（ARFID）是一种儿童喂养和进食障碍，常伴有明显的身体和心理社会损害。
我们评估了非典型抗精神病药物（AAP）（主要是利培酮）在促进ARFID儿童体重和身高增长方面的应用。
对以色列一个中心21例接受AAP治疗的ARFID儿童的计算机化病历进行回顾性分析。14例儿童在采用常规治疗（团体或个体认知行为疗法）体重未增加6.30±0.75个月后接受了AAP治疗；7例儿童因体重未增加而在之前的机构接受AAP治疗后转入我们的诊所。所有儿童均随访18个月。在八个时间点从病历中提取体重和身高数据。
在使用AAP治疗的18个月期间，体重、身高和体重指数（BMI）均显著增加（体重变化：9.66±9.24kg，p<0.001；身高变化：10.23±11.54cm，p<0.001；BMI变化=2.55±1.53kg/m²；p<0.001）。男女体重均显著增加，而仅男孩身高显著增加。基线BMI百分位数低和高的患者体重均增加，而仅BMI百分位数低的儿童平均身高随时间显著增加。采用回顾性临床总体印象量表显示，随着时间推移有显著改善。不良反应轻微，无患者因不良事件停用AAP。
在ARFID儿童中添加AAP治疗18个月可能对增加体重和身高安全有效。
