Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Nov 6;11(11):CD014834.
doi: 10.1002/14651858.CD014834.

Antipsychotic drugs for anorexia nervosa

Kazufumi Yoshida  1 , Hissei Imai  1   2 , Ethan Sahker  1   3 , Yan Luo  4 , Shino Kikuchi  5 , Yasushi Tsujimoto  6   7 , Ioannis Michopoulos  8 , Toshi A Furukawa  1 , Norio Watanabe  7   9
Affiliations

Antipsychotic drugs for anorexia nervosa

Kazufumi Yoshida et al. Cochrane Database Syst Rev. .

Abstract

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of antipsychotic drugs (both first- and second-generation antipsychotics) compared to placebo on body weight gain, psychological symptoms, acceptability, and adverse events for people with anorexia nervosa.

PubMed Disclaimer

Conflict of interest statement

KY has no known conflict of interest. HI received an honorarium for a lecture from Otsuka Pharmaceutical Co., Ltd. ES has no known conflict of interest. YL reports two research grants from Japan Society for the Promotion of Science KAKENHI (grant number JP22K21112, JP23K16355) outside this work. SK has no known conflict of interest. YT reports grants from Japan Society for the Promotion of Science, Kyoto University, and Pfizer Foundation, outside the submitted work. In addition, YT is a board member of Cochrane Japan and works as a physician at Oku Medical Clinic. IM has no known conflicts of interest. TAF reports personal fees from Boehringer‐Ingelheim, Daiichi Sankyo, DT Axis, Kyoto University Original, Micron, Shionogi, SONY and UpToDate, and a grant from DT Axis and Shionogi, outside the submitted work. In addition, TAF has a patent 7448125 and a pending patent 2022‐082495, and has licensed intellectual properties for Kokoro‐app to Mitsubishi‐Tanabe.

References

Additional references

Allison 1999
    1. Allison DB, Mentore JL, Heo M, Chandler LP, Cappelleri JC, Infante MC, et al. Antipsychotic-induced weightgain: a comprehensive research synthesis. American Journal of Psychiatry 1999;156(11):1686-96. - PubMed
Alonso‐Pedrero 2019
    1. Alonso-Pedrero L, Bes-Rastrollo M, Marti A. Effects of antidepressant and antipsychotic use on weight gain: a systematic review. Obesity Reviews 2019;20(12):1680-90. - PubMed
Altman 1996
    1. Altman DG, Bland MJ. Detecting skewness from summary information. BMJ 1996;313(7066):1200. - PMC - PubMed
APA 2006
    1. American Psychiatric Association (APA). Practice Guidelines for the Treatment of Psychiatric Disorders. 3rd edition. Arlington, Verginia (USA): APA, 2006.
APA 2012
    1. American Psychiatric Association (APA). Guideline watch (August 2012): practice guideline for the treatment of patients with eating disorders. 3rd edition. APA, 2012.
APA 2013
    1. American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders. 5th edition. Washington, DC (USA): APA, 2013.
Arcelus 2011
    1. Arcelus J, Mitchell AJ, Wales J. Mortality rates in patients with anorexia nervosa and other eating disorders. Archives of General Psychiatry 2011;68(7):724-31. - PubMed
Attia 2019
    1. Attia E, Steinglass JE, Walsh TB, Wang Y, Wu P. Olanzapine versus placebo in adult outpatients with anorexia nervosa: a randomized clinical trial. American Journal of Psychiatry 2019;176(6):449-56. - PMC - PubMed
Bak 2014
    1. Bak M, Fransen A, Janssen J, Van JO, Drukker M. Almost all antipsychotics result in weight gain: a meta-analysis. PLoS ONE 2014;9(4):1-19. - PMC - PubMed
Barton 2020
    1. Barton BB, Segger F, Fischer K, Obermeier M, Musil R. Update on weight-gain caused by antipsychotics: a systematic review and meta-analysis. Expert Opinion on Drug Safety 2020;19(3):295-314. - PubMed
Beykloo 2019
    1. Beykloo MY, Nicholls D, Simic M, Brauer R, Mills E, Wong ICK. Survey on self-reported psychotropic drug prescribing practices of eating disorder psychiatrists for the treatment of young people with anorexia nervosa. BMJ Open 2019;9(9):1-6. - PMC - PubMed
Chesney 2014
    1. Chesney E, Goodwin GM, Fazel S. Risks of all-cause and suicide mortality in mental disorders: a meta-review. World Psychiatry 2014;13(2):153-60. - PMC - PubMed
Cohen 1988
    1. Cohen J. Statistical Power Analysis in the Behavioral Sciences. 2nd edition. Hillsdale (NJ): Lawrence Erlbaum Associates, Inc., 1988.
Cooper 1989
    1. Cooper Z, Cooper PJ, Fairburn CG. The validity of the eating disorder examination and its subscales. British Journal of Psychiatry 1989;154:807-12. - PubMed
Cumpston 2023
    1. Cumpston M, Lasserson T, Flemyng E, Page MJ. Chapter III: Reporting the review. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. Available from www.training.cochrane.org/handbook.
Deeks 2023
    1. Deeks JJ, Higgins JP, Altman DG (editors). Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. Available from www.training.cochrane.org/handbook.
DerSimonian 1986
    1. DerSimonian R, Laird N. Meta-analysis in clinical trials. Controlled Clinical Trials 1986;7(3):177-88. - PubMed
Dold 2015
    1. Dold M, Aigner M, Klabunde M, Treasured J, Kaspera S. Second-generation antipsychotic drugs in anorexia nervosa: a meta-analysis of randomized controlled trials. Psychotherapy and Psyhcosomatics 2015;84:110-6. - PubMed
Egger 1997a
    1. Egger M, Zellweger-Zähner T, Schneider M, Junker C Lengeler C, Antes G. Language bias in randomised controlled trials published in English and German. Lancet 1997;350(9074):326-9. - PubMed
Egger 1997b
    1. Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. British Medical Journal 1997;315(7109):629-34. - PMC - PubMed
Fazeli 2012
    1. Fazeli PK, Calder GL, Miller KK, Misra M, Lawson EA, Meenaghan E, et al. Psychotropic medication use in anorexia nervosa between 1997 and 2009. International Journal of Eating Disorders 2012;45(8):970-6. - PMC - PubMed
Fisher 2019
    1. Fisher CA, Skocic S, Rutherford KA, Hetrick SE. Family therapy approaches for anorexia nervosa. Cochrane Database of Systematic Reviews 2019, Issue 5. Art. No: CD004780. [DOI: 10.1002/14651858.CD004780.pub4] - DOI - PMC - PubMed
Furukawa 2006
    1. Furukawa TA, Barbui C, Cipriani A, Brambilla P, Watanabe N. Imputing missing standard deviations in meta-analyses can provide accurate results. Journal of Clinical Epidemiology 2006;59(1):7-10. - PubMed
Garner 1991
    1. Garner DM. Eating Disorder Inventory-2: professional manual. Psychological Assessment Resources, 1991.
Gitlin 2012
    1. Gitlin LN, Kales HC, Lyketsos CG. Nonpharmacologic management of behavioral symptoms in dementia. Journal of the American Medical Association 2012;308(19):2020-9. - PMC - PubMed
Guyatt 2011
    1. Guyatt G, Oxman A, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction - GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology 2011;64(4):383-94. - PubMed
Han 2022
    1. Han R, Bian Q, Chen H. Effectiveness of olanzapine in the treatment of anorexia nervosa: A systematic review and meta-analysis. Brain and Behavior 2022;12(2):e2498. - PMC - PubMed
Hasnain 2012
    1. Hasnain M, Vieweg WVR, Hollett B. Weight gain and glucose dysregulation with second-generation antipsychotics and antidepressants: a review for primary care physicians. Postgraduate Medicine 2012;124(4):154-67. - PubMed
Higgins 2023a
    1. Higgins JP, Savović J, Page MJ, Elbers RG, Sterne JA. Chapter 8: Assessing risk of bias in a randomized trial [last updated October 2019]. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane, 2024. Available from www.training.cochrane.org/handbook.
Higgins 2023b
    1. Higgins JP, Eldridge S, Li T (editors). Chapter 23: Including variants on randomized trials [last updated October 2019]. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane, 2024. Available from www.training.cochrane.org/handbook.
Higgins 2023c
    1. Higgins JP, Li T, Deeks JJ (editors). Chapter 6: Choosing effect measures and computing estimates of effect [last updated August 2023]. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.5. Cochrane, 2024. Available from www.training.cochrane.org/handbook.
Hudson 2007
    1. Hudson JI, Hiripi E, Pope HG, Kessler RC. The prevalence and correlates of eating disorders in the national comorbidity survey replication. Biological Psychiatry 2007;61(2):348-58. - PMC - PubMed
Jobski 2017
    1. Jobski K, Höfer J, Hoffmann F, Bachmann C. Use of psychotropic drugs in patients with autism spectrum disorders: a systematic review. Acta Psychiatrica Scandinavica 2017;135(1):8-28. - PubMed
Lefebvre 2023
    1. Lefebvre C, Glanville J, Briscoe S, Featherstone R, Littlewood A, Metzendorf M-I, et al. Chapter 4: Searching for and selecting studies. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated October 2023). Cochrane, 2023. Available from www.training.cochrane.org/handbook.
Leucht 2009
    1. Leucht S, Corves C, Arbter D, Engel RR, Li C, Davis JM. Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 2009;373(9657):31-41. - PubMed
Leucht 2013
    1. Leucht S, Cipriani A, Spineli L, Mavridis D, Örey D, Richter F, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet 2013;382(9896):951-62. - PubMed
Liberati 2009
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700. - PMC - PubMed
Maher 2011
    1. Maher AR, Maglione M, Bagley S, Suttorp M, Hu J, Ewing B, Wang Z, Timmer M, Sultzer D. Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults. JAMA 2011;306(12):1359-69. - PubMed
Mazure 1994
    1. Mazure CM, Halmi KA, Sunday SR, Romano SJ, Einhorn AM. The Yale-Brown-Cornell Eating Disorder Scale: development, use, reliability and validity. Journal of Psychiatric Research 1994;28(5):425-45. - PubMed
McKenzie 2023
    1. McKenzie JE, Brennan SE. Chapter 12: Synthesizing and presenting findings using other methods. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023. Available from www.training.cochrane.org/handbook.
Montastruc 2015
    1. Montastruc F, Palmaro A. Role of serotonin 5-HT 2C and histamine H 1 receptors in antipsychotic-induced diabetes: a pharmacoepidemiological-pharmacodynamic study in VigiBase. European Neuropsychopharmacology 2015;25:1556-65. - PubMed
Musil 2015
    1. Musil R, Obermeier M, Russ Pl, Hamerle M. Weight gain and antipsychotics: a drug safety review. Expert Opinion on Drug Safety 2015;14(1):73-96. - PubMed
NICE 2017
    1. Eating disorders: recognition and treatment [NG69]. National Institute for Health and Care Excellence (NICE) 2017. - PubMed
Ouzzani 2016
    1. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Systematic Reviews 2016;5(1):210. - PMC - PubMed
Parsons 2009
    1. Parsons B, Allison DB, Loebel A, Williams K, Giller E, Romano S, Siu C. Weight effects associated with antipsychotics: a comprehensive database analysis. Schizophrenia Research 2009;110(1-3):103-10. - PubMed
Pike 2003
    1. Pike KM, Walsh BT, Vitousek K, Wilson GT, Bauer J. Cognitive behavior therapy in the posthospitalization treatment of anorexia nervosa. The American Journal of Psychiatry 2003;160(11):2046-9. - PubMed
Pillinger 2020
    1. Pillinger T, McCutcheon RA, Vano L, Mizuno Y, Arumuham A, Hindley G, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry 2020;7(1):64-77. - PMC - PubMed
Preti 2009
    1. Preti A, Girolamo G, Vilagut G, Alonso Ji, Graaf R, Bruffaerts R, et al. The epidemiology of eating disorders in six European countries: results of the ESEMeD-WMH project. Journal of Psychiatric Research 2009;43(14):1125-32. - PubMed
RANZCP 2014
    1. Hay P, Chinn D, Forbes D, Madden S, Newton R, Sugenor L, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders. Australian and New Zealand Journal of Psychiatry 2014;48(11):977-1008. - PubMed
RevMan 2023 [Computer program]
    1. Review Manager (RevMan). Version 7.1.2. The Cochrane Collaboration, 2023. Available at revman.cochrane.org.
Rizzo 2019
    1. Rizzo SM, Douglas JW, Lawrence JC. Enteral Nutrition via Nasogastric Tube for Refeeding Patients With Anorexia Nervosa: A Systematic Review. Nutrition in Clinical Practice 2019;34(3):359-370. - PubMed
Russell 1970
    1. Russell GFM. Anorexia nervosa: its identity as an illness and its treatment. London: Modern Trends in Psychological Medicine, 1970.
Serfaty 1999
    1. Serfaty MA, Turkington D, Heap M, Ledsham L, Jolley E. Cognitive therapy versus dietary counselling in the outpatient treatment of anorexia nervosa: effects of the treatment phase. European Eating Disorders Review 1999;7(5):334-340.
Sterne 2011
    1. Sterne JAC, Sutton AJ, Ioannidis JPA, Terrin N, Jones DR, Lau J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomised controlled trials. BMJ 2011;343:1-8. - PubMed
Tarricone 2010
    1. Tarricone I, Ferrari GB, Serretti A, Grieco D, Berardi D. Weight gain in antipsychotic-naive patients: a review and meta-analysis. Psychological Medicine 2010;40(2):187-200. - PubMed
Thorey 2023
    1. Thorey S, Blanchet C, Guessoum SB, Moro MR, Ludot M, Carretier E. Efficacy and tolerance of second-generation antipsychotics in anorexia nervosa: A systematic scoping review. PLoS One 2023;18(3):e0278189. - PMC - PubMed
Treasure 2020
    1. Treasure J, Duarte TA, Schmidt U. Eating disorders. Lancet 2020;395(10227):899-911. - PubMed
Udo 2018
    1. Udo T, Grilo CM. Prevalence and correlates of DSM-5–defined eating disorders in a nationally representative sample of U.S. adults. Biological Psychiatry 2018;84(5):345-54. - PMC - PubMed
Van den Berg 2019
    1. Van den Berg E, Houtzager L, Vos J, Daemen I, Katsaragaki G, Karyotaki E, et al. Meta-analysis on the efficacy of psychological treatments for anorexia nervosa. European Eating Disorders Review 2019;27(4):331-51. - PubMed
Vandenberghe 2016
    1. Vandenberghe F, Gholam-Rezaee M, Saigí-Morgui N, Delacrétaz A, Choong E, Solida-Tozzi A, et al. Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment. Journal of Clinical Psychiatry 2016;76(11):e1417-23. - PubMed
WHO 1992
    1. World Health Organization. The ICD-10 classification of mental and behavioral disorders. World Health Organization, 1992.
Zeeck 2018
    1. Zeeck A, Herpertz-Dahlmann B, Friederich HC, Brockmeyer T, Resmark G, Hagenah U, et al. Psychotherapeutic treatment for anorexia nervosa: A systematic review and network meta-analysis. Frontiers in Psychiatry 2018;9(158):1-14. - PMC - PubMed
Zipfel 2015
    1. Zipfel S, Giel KE, Bulik CM, Hay P, Schmidt U. Anorexia nervosa: aetiology, assessment, and treatment. Lancet Psychiatry 2015;2(12):1099-111. - PubMed

MeSH terms

Substances

LinkOut - more resources