F.E.A.S.T's Around The Dinner Table forum

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Hesic1092
My 14 year old has been diagnosed with AN and her behavior has been atrocious ALL the time, not just around eating.   It's getting worse and the stress of it all on our family is taking a  huge toll on us.  She is swearing, yelling, angry, throwing things, sad, crying constantly (except when she is with her friends or at school).  Our Doc has  recommended we try Olanzapine  Wondering if anyone else has any experience with this?  I'd appreciate hearing from anyone on your experience with this?  Good or bad
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scaredmom
Olanzapine has good data/ evidence in AN.
We has tried it for a few weeks with d early in refeeding, but no effect for my d.
it can help calm them down and sleep better and help their thoughts.
I will find some threads and articles  for you and post them, a bit later.

I do feel meds, when used and under medical supervision can be very helpful.
it may help your child feel better, they deserve to feel better and meds are another tool in your tool box.
XXX
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Hesic1092
Thank you 
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scaredmom

https://www.aroundthedinnertable.org/post/olanzapine-zyprexa-9482081?highlight=olanzapine&pid=1301912625#gsc.tab=0

Interesting, just found a New England Journal of Medicine abstract saying the Olanzapine was not helpful.
https://www.jwatch.org/na48346/2019/02/01/olanzapine-anorexia-nervosa

And in 2017 "Maybe it was helpful"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5528990/

And another that discussed faster weight gain in those on Olanzapine.
https://www.mdedge.com/psychiatry/article/104066/pediatrics/aacap-faster-weight-gain-olanzapine-anorexia

Lots of information!

Hope some of this helps
XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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scaredmom
Many psychotropic drugs can be used for many different reasons.
some evidence for zyprexa with weight gain and some evidence of no weight gain  in other trials and also the effects on cognition/emotions etc. If you try one med, give it about 6 weeks to see if it helps and then if not, you may discuss with your team to try another med.

my d is on sertraline and she felt it helpful with anxiety overall. 

I am sure others will be here with their experience with olanzapine or other meds.

XXX
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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melstevUK
If docs agree to it, it might be worth trying Mirtazapine as this acts on the adrenal system as well as serotonin system - and may help with sleep and overall anxiety.  It's not an antipsychotic (which affects dopamine system).
In between the screaming sessions it is probably worth trying to put ground rules down around behaviour.  There are different views on this - some parents accept the violence if the food goes in, some try and rein back the violence at the same time.  Everyone has to find their own way of managing these episodes, which usually stop once a regime of eating is accepted, the weight starts to go on and cognitive functioning improves.
I would be tempted to tell d that, however much she is suffering and fears eating, she has to learn to accept it without all the screaming and shouting, and see what conversation that brings about.  Acknowledging just how hard this process and journey are going to be may help, all while stating that she cannot behave like this  because it is too distressing for the rest of the family.
Believe you can and you're halfway there.
Theodore Roosevelt.
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Hesic1092
Thanks you melstevUK
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Robin1
Hi Hesic1092, our almost 14yo D is on 5mg Olanzapine. I believe it has helped her, particularly with sleeping at night - she was having terrible nightmares. We resisted medication at first but her anxiety was off the scale with all the behaviours you mention. She started on a very low dose and this has gradually increased as anxiety rose during refeeding. Now she is recently wr or close her anxiety seems to be falling so she may be able to start to come off this soon. 
For what its worth, we tried everything to reinforce boundaries with D with respect to her behaviours but sometimes her anxiety was just too high for her to control. We have worked at lots of anxiety reducing measures in addition to medication to try to bring her baseline anxiety down so that when it spikes its not as high. The toughest period was 90-95% w2h when her anxiety rocketed. We pushed through and saw improvements.
Rx

R x
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Hesic1092
Thank you Robin1,  This is helpful.   I'm new to all of this, I assume wr means "weight restored".  What does w2h mean?  "weight to height"?  I haven't heard this term before
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tina72
WR means she is on a good weight for her body,
Weight for heigh means that when she is on 75% percentile for heigh she should normally be also on 75% percentile for weight. Some are very tall and thin and have been at 75% high and 50% weight all their life, than this is o.k. But when she has been on 50% weight all her life up to now 25% percentile is not enough for her personal body.
Sorry, we use a lot of shortcuts here...ask please if you do not understand something.
Keep feeding. There is light at the end of the tunnel.
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Foodsupport_AUS
My D also used Olanzapine but not for behavioural issues. For her it was to help with ongoing rumination and to try to help her anxiety around eating. It made no difference to the anxiety for eating but it did help for sleeping constant thoughts overnight. We also used fluoxetine initially for mood and then sertraline and finally ended up on venlafaxine for mood. She has recently switched to duloxetine as she had weird side effect of tooth grinding from the venlafaxine. 

As for weight for height, as TIna mentioned it is based on the assumption that for most of the population weight and height are fairly closely linked. So if you are on the 50th centile for weight and height then you will be 100% weight for height. The same does not apply if you are for example 90th centile height and weight as it is actually based on a BMI being on the 50th percentile and because weight varies much more than height they don't always match up.  It requires access to tables or an app https://itunes.apple.com/gb/app/instant-weight-for-height/id1107990045?mt=8

This article has nothing to do with ED but does discuss the relative merits of using BMI percentile or Weight for height for short and tall kids. https://academic.oup.com/ajcn/article/80/4/982/4690406
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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Mumoffantasticboy
My 14 year old son is inpatient at the moment - 9 weeks into a 12 week min programme.  Started Olanzepine at 2.5mg and just started Setraline.  Has gone from 76% weight to height to 97%.   Mood much improved.  No evidence of suicidal thoughts now and his pre-anorexia personality has returned :-).  Now has cognition of his illness and ( what appears to be, but watching like a hawk in case not) a steely determination to fight the anorectic voices.  
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tina72
That sounds very good. Keep feeding and watch him like a hawk and he will get better soon!
Keep feeding. There is light at the end of the tunnel.
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