Treatment of anorexia nervosa with long-term risperidone in an outpatient setting: case studyReport as inadecuate

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IntroductionThere are currently few studies focusing on the efficacy of long-term atypical antipsychotics to treat anorexia nervosa in the pediatric population.

Case descriptionThis case report follows the treatment of a 17 year-old female with anorexia nervosa over her four-year undergraduate career. After two years of multidisciplinary treatment, low-dose risperidone was initiated due to persistence of her disease. She expressed decreased rigidity around meal times, her weight improved and she had resumption of menses. She was compliant with treatment through graduation and maintained her weight gain.

Discussion and evaluationAtypical antipsychotics are a treatment option in the management of anorexia nervosa. Risperidone has not been studied as frequently as olanzapine for eating disorders. Risperidone was chosen for its more favorable side effect profile and decreased cost to the patient. Previous studies on anorexia nervosa treatment have occurred during inpatient treatment and have limited follow-up due to patients’ refusal to initiate or maintain medication compliance. This case presents 17 months of outpatient data. The efficacy of risperidone therapy was evaluated with frequent weight checks, subjective decrease in rigidity, serial complete metabolic panels, and restoration of menses.

ConclusionsIn this case report, an adolescent female treated with low-dose risperidone had decreased rigid thinking, weight gain and resolution of secondary amenorrhea without medication side effects. Therefore, the atypical antipsychotic risperidone may be an effective long-term outpatient treatment option for patients with anorexia nervosa.

KeywordsAnorexia nervosa Risperidone Secondary amenorrhea Eating disorders Outpatient treatment Case report AbbreviationsANAnorexia nervosa

SSRIsSelective serotonin reuptake inhibitors

BMIBody mass index.

Electronic supplementary materialThe online version of this article doi:10.1186-2193-1801-3-706 contains supplementary material, which is available to authorized users.

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Author: Elsa J Kracke - Aneesh K Tosh


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