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Atypical antipsychotics as augmentation therapy in anorexia nervosa.

Marzola E, Desedime N, Giovannone C, Amianto F, Fassino S, Abbate-Daga G - PLoS ONE (2015)

Bottom Line: Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures.Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size.Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions.

View Article: PubMed Central - PubMed

Affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy.

ABSTRACT
Anorexia nervosa (AN) is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder. We aimed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors (SSRIs) in adult inpatients affected by AN. We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014. Patients were evaluated upon admission and discharge. We investigated eating symptomatology, and both general and eating psychopathology using: Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale. The charts of 75 patients were included in this study. The sample resulted equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs. Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures. Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size. The body of evidence on medication management in AN is in dismal condition. Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well. Nevertheless, to date very little data is available on this topic. Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions. Randomized controlled trials are warranted to confirm these encouraging findings.

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Related in: MedlinePlus

Changes in Yale-Brown-Cornell Eating Disorders Scale (YBC-EDS) total score (1a) and preoccupations (1b) and rituals (1c) subscales amongst groups of treatment at admission (T0) and discharge (T1).All groups significantly improved on all YBC-EDS scales but those patients undergoing aripiprazole in combination with Selective Serotonin Reuptake Inhibitors (SSRIs) reported a significantly larger improvement when compared to the other groups. Mean scores and 95% confidence intervals are shown as columns and bars, respectively.
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pone.0125569.g001: Changes in Yale-Brown-Cornell Eating Disorders Scale (YBC-EDS) total score (1a) and preoccupations (1b) and rituals (1c) subscales amongst groups of treatment at admission (T0) and discharge (T1).All groups significantly improved on all YBC-EDS scales but those patients undergoing aripiprazole in combination with Selective Serotonin Reuptake Inhibitors (SSRIs) reported a significantly larger improvement when compared to the other groups. Mean scores and 95% confidence intervals are shown as columns and bars, respectively.

Mentions: As shown in Table 3, at the two time-points considered the three groups did not differ significantly from one another as regards anxiety (i.e., HAM-A). In contrast, differences on depression (i.e., HAM-D) and eating-related rituals and preoccupations (i.e., YBC-EDS total score and both preoccupations and rituals subscales) emerged. As shown in Table 3, OLA showed a trend towards a greater effect than SSRIs on depression. With respect to eating preoccupations and rituals, ARI reported a significantly greater improvement with a large effect size on the global score and both subscales of the YBC-EDS when compared to both other groups (Fig 1).


Atypical antipsychotics as augmentation therapy in anorexia nervosa.

Marzola E, Desedime N, Giovannone C, Amianto F, Fassino S, Abbate-Daga G - PLoS ONE (2015)

Changes in Yale-Brown-Cornell Eating Disorders Scale (YBC-EDS) total score (1a) and preoccupations (1b) and rituals (1c) subscales amongst groups of treatment at admission (T0) and discharge (T1).All groups significantly improved on all YBC-EDS scales but those patients undergoing aripiprazole in combination with Selective Serotonin Reuptake Inhibitors (SSRIs) reported a significantly larger improvement when compared to the other groups. Mean scores and 95% confidence intervals are shown as columns and bars, respectively.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4414549&req=5

pone.0125569.g001: Changes in Yale-Brown-Cornell Eating Disorders Scale (YBC-EDS) total score (1a) and preoccupations (1b) and rituals (1c) subscales amongst groups of treatment at admission (T0) and discharge (T1).All groups significantly improved on all YBC-EDS scales but those patients undergoing aripiprazole in combination with Selective Serotonin Reuptake Inhibitors (SSRIs) reported a significantly larger improvement when compared to the other groups. Mean scores and 95% confidence intervals are shown as columns and bars, respectively.
Mentions: As shown in Table 3, at the two time-points considered the three groups did not differ significantly from one another as regards anxiety (i.e., HAM-A). In contrast, differences on depression (i.e., HAM-D) and eating-related rituals and preoccupations (i.e., YBC-EDS total score and both preoccupations and rituals subscales) emerged. As shown in Table 3, OLA showed a trend towards a greater effect than SSRIs on depression. With respect to eating preoccupations and rituals, ARI reported a significantly greater improvement with a large effect size on the global score and both subscales of the YBC-EDS when compared to both other groups (Fig 1).

Bottom Line: Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures.Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size.Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions.

View Article: PubMed Central - PubMed

Affiliation: Eating Disorders Center for Treatment and Research, Department of Neuroscience, University of Turin, Turin, Italy.

ABSTRACT
Anorexia nervosa (AN) is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder. We aimed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors (SSRIs) in adult inpatients affected by AN. We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014. Patients were evaluated upon admission and discharge. We investigated eating symptomatology, and both general and eating psychopathology using: Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression, and Yale-Brown-Cornell Eating Disorders Scale. The charts of 75 patients were included in this study. The sample resulted equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs. Notwithstanding a few baseline clinical differences, upon discharge all groups were significantly improved on all measures. Interestingly, aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size. The body of evidence on medication management in AN is in dismal condition. Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well. Nevertheless, to date very little data is available on this topic. Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions. Randomized controlled trials are warranted to confirm these encouraging findings.

Show MeSH
Related in: MedlinePlus