Olanzapine and Eating Disorders

Eating disorder behaviors cannot be treated solely using psychotropic medications, however, psychotropic medication can help in the treatment of eating disorders.

If this sounds like a riddle to you, please read further. Medication alone does not directly reduce or extinguish eating disorder behaviors such as binging, purging, or restricting. What medication can support is the treatment of mood, appetite, and sleep disturbances that contribute to eating disorder development and maintenance.

One family of psychiatric medications that researchers look to for part of eating disorder treatment are atypical antipsychotics.

Also known as “second generation antipsychotics,” these treat symptoms similar to “first generation antipsychotics,” however, they do not have the same degree of negative motor control and coordination side effects.

The formal name for one atypical antipsychotic that is often used in the treatment of eating disorders is Olanzapine, which is more often referred to as the brand-name Zyprexa.

Using Zyprexa for Eating Disorders

Olanzapine is most widely used to treat Anorexia Nervosa, which will be discussed below, however, this does not mean it isn’t effective in treating eating disorder symptomatology outside of Anorexia Nervosa behaviors and behavior patterns.

When included in eating disorder treatment, Olanzapine is “used to reduce extreme beliefs regarding body image and eating-related disturbed thoughts such as intense ruminations about food, pseudo-hallucinations as well as the hyper-arousal and agitation found when people are confronted with weight gain [1].” This can be helpful in treating all eating disorders.

Further, olanzapine has interestingly supported increased weight gain and reduced depressive symptoms in those with Binge/Purge Type Anorexia Nervosa only [1].

Does Olanzapine Treatment for Patients with Anorexia Nervosa Work?

The initial idea behind using Olanzapine to treat Anorexia Nervosa was related to the side effects of the medication which included increased appetite and weight gain [2].

While these effects certainly contribute to the effectiveness of Olanzapine treatment for Anorexia Nervosa, other benefits have also shown themselves such as “improvement of obsessive symptoms.” Individuals with Anorexia Nervosa struggle greatly with obsessiveness over food, weight, body shape and size, food rules, etc. Olanzapine has shown to be effective in reducing these obsessive fixations as well as reducing rigid thought processes [1].

Anorexia Nervosa is also characterized by symptoms of anxiety such as ruminating and fear-based thoughts as well as black-and-white thinking. Research has been found to be helpful in treating these symptoms as well [2].

Olanzapine also supports in “reducing psychological distress particularly in the refeeding phase of anorexia nervosa treatment [1].”

Possible Olanzapine Side Effects

According to the National Alliance on Mental Illness (NAMI), the following are potential side effects of Olanzapine:

• “Low blood-pressure.
• Drowsiness.
• Restlessness.
• Dizziness
• Headache.
• Fatigue.
• Insomnia.
• Increased Prolactin.
• Weight gain.
• Increased appetite.
• Dry Mouth.
• Indigestion.
• Constipation.
• Liver function test abnormalities.
• Weakness
• Accidental injury [3].”

Benefits of Atypical Antipsychotics in Eating Disorder Treatment

The list above might seem frighteningly long to you and have you wondering whether there are any benefits to taking Olanzapine that could outweigh the potential consequences.

However, benefits of Olanzapine use include treatment of the following:

• “Hallucinations — imagined voices or images that seem real
• Delusions — beliefs that are not true (e.g., other people are reading your thoughts)
• Disorganized thinking or trouble organizing your thoughts and making sense
• Little desire to be around other people
• Trouble speaking clearly
• Lack of motivation [3].”

Further, Olanzapine is approved by the Food and Drug Administration (FDA) for the following disorders that commonly co-occur with eating disorders:

• Acute treatment of manic or mixed episodes of bipolar disorder
• Maintenance (long-term) treatment of bipolar disorder
• Acute treatment of agitation in schizophrenia and bipolar disorder [3].

Taking any medication is certainly something to explore with your mental health team which should include, at minimum, a professional Psychiatrist.

There are many unknown factors to how each individual will respond to a medication, however, what is known is that this psychotropic medication has proven to be effective in supporting eating disorder recovery in numerous studies.

While no drug can simply “get rid” of eating disorder behaviors and lead to immediate recovery, psychotropic medications can provide supplemental support as one engages in the appropriate level of treatment with nutritional, medical, and therapeutic professionals.

Resources

[1] Hay, P. J., Claudino, A. M. (2012). Clinical psychopharmacology of eating disorders: a research update. International Journal of Neuropsychopharmacology, 5.

[2] Norris, M. L., et al. (2011). Olanzapine use for adjunctive treatment of adolescents with anorexia nervosa. Journal of Child and Adolescent Psychopharmacology, 21:3.

[3] Unknown (2020). Olanzapine (zyprexa). National Alliance on Mental Illness. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Olanzapine-(Zyprexa).

Author: Margot Rittenhouse, MS, LPC, NCC
Page Last Reviewed on March 28, 2022, and Updated By: Jacquelyn Ekern, MS, LPC