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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0498

Bridging the gap between evidence and practice: olanzapine use in children and young people with anorexia nervosa

BRIDGING THE GAP BETWEEN EVIDENCE AND PRACTICE: OLANZAPINE USE IN CHILDREN AND YOUNG PEOPLE WITH ANOREXIA NERVOSA

Although high-quality evidence is limited, consistent findings from observational studies suggest that olanzapine has a role as an adjunctive treatment in selected cases of anorexia nervosa.

The aim of the study is to synthesize current evidence on olanzapine use for anorexia nervosa (AN) in children and young people (CYP) under 18 years of age and to examine the gap between evidence and practice. A narrative synthesis was conducted of randomized controlled trials, open-label studies, observational studies, and case reports published between 2000 and 2025 and identified across multiple databases; data on efficacy, tolerability, and clinical outcomes were evaluated. A total of 36 studies were included. Olanzapine was associated with modest weight gain, reductions in anxiety and agitation, and increased engagement with nutritional and psychological interventions; reduced cognitive rigidity and refeeding-related distress were reported as additional benefits. By study type, randomized controlled trials had small samples, insufficient statistical power, and short follow-up periods, and showed modest increases in body mass index (BMI) and inconsistent psychological changes; in open-label and naturalistic studies, low-dose olanzapine (2.5 to 5 mg/day) was associated with increased BMI and reductions in anxiety, rigidity, and pre-meal distress, but these studies lacked control groups. Guidelines (NICE, RCPsych, Maudsley) do not routinely recommend olanzapine, but state that it may be considered in severe cases within a multidisciplinary team; therapeutic drug monitoring may play a role in improving safety. The evidence base remains limited by small samples, short study durations, and methodological heterogeneity, while safety concerns and uncertainty in guidelines create a persistent gap between clinicians’ prescribing confidence and the evidence. The clinical implications are that olanzapine should be considered as an adjunct to family-based and multidisciplinary treatment, with shared decision-making involving families, monitoring of weight, metabolic parameters, and adverse effects throughout treatment, and use within recognized off-label prescribing frameworks.

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