{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T12:49:56Z","timestamp":1789044596089,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Eating disorders (EDs), particularly Anorexia Nervosa (AN), remain one of the most severe and treatment-resistant eating disorders, with high relapse rates and limited pharmacological options. While second-generation antipsychotics and antidepressants are commonly prescribed as adjuncts to nutritional rehabilitation, their real-world impact on weight restoration and psychopathological symptom severity remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective, naturalistic observational study of 127 inpatients diagnosed with restrictive anorexia nervosa (AN-r), binge\u2013purge anorexia nervosa (AN-bp), or bulimia nervosa (BN). BMI and weekly psychopathological symptom burden were systematically monitored throughout a ten-week inpatient treatment program. Psychopharmacological treatments were recorded in real time, and the Average Morbidity Index (AMI), adapted from the Life Chart Methodology, was computed weekly as a prospective measure of clinical severity. Generalized Linear Models assessed the associations between specific drug classes and changes in BMI and AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients treated with mood stabilizers (e.g., Carbamazepine, Lithium) showed a smaller BMI increase compared to other groups (Coef. = \u20130.96 to \u20131.70; p&amp;lt; 0.05), suggesting a potential weight-stabilizing effect. Diazepam use was associated with greater weight gain (Coef. = +2.06; p = 0.02) but no clear benefit on AMI. Several antidepressants (e.g., Sertraline, Escitalopram) correlated with higher AMI scores, indicating less improvement in psychopathological symptom burden. Atypical antipsychotics (e.g., Olanzapine, Aripiprazole) were linked to greater reductions in AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prospective monitoring of BMI and AMI revealed differential associations between psychopharmacological agents and both nutritional and symptomatic trajectories in an inpatient ED cohort predominantly composed of patients with AN. Mood stabilizers were associated with smaller BMI increases, while several antidepressants corresponded to less improvement in psychopathological symptom burden. Atypical antipsychotics showed the strongest prospective reductions in AMI. These findings highlight the value of prospective, real-world monitoring to inform pharmacological strategies in treatment-resistant eating disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1750187","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T07:20:23Z","timestamp":1769412023000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of psychopharmacological combinations on psychopathological symptom burden and BMI trajectories in patients with eating disorders"],"prefix":"10.3389","volume":"17","author":[{"given":"Ernesta","family":"Panarello","sequence":"first","affiliation":[{"name":"Department of Mental Health, ASL Salerno","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Monaco","sequence":"additional","affiliation":[{"name":"Department of Mental Health, ASL Salerno","place":["Salerno, Italy"]},{"name":"European Biomedical Research Institute of Salerno (EBRIS)","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Di Stefano","sequence":"additional","affiliation":[{"name":"Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annarita","family":"Vignapiano","sequence":"additional","affiliation":[{"name":"Department of Mental Health, ASL Salerno","place":["Salerno, Italy"]},{"name":"European Biomedical Research Institute of Salerno (EBRIS)","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Zaffonte","sequence":"additional","affiliation":[{"name":"Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Pullano","sequence":"additional","affiliation":[{"name":"Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Corrivetti","sequence":"additional","affiliation":[{"name":"Department of Mental Health, ASL Salerno","place":["Salerno, Italy"]},{"name":"European Biomedical Research Institute of Salerno (EBRIS)","place":["Salerno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Luca","family":"Steardo","sequence":"additional","affiliation":[{"name":"Psychiatric Unit, Department of Health Sciences, University Magna Graecia of Catanzaro","place":["Catanzaro, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Fornaro","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Reproductive Sciences, and Dentistry, Section of Psychiatry, University School of Medicine Federico II","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14691","article-title":"Current approach to eating disorders: A clinical update","volume":"50","author":"Hay","year":"2020","journal-title":"Intern Med J"},{"key":"B2","unstructured":"Eating disorders (Quality standard QS175)\n          \n          \n          \n          2018"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2010.05.017","article-title":"Lifetime prevalence of mental disorders in U.S. adolescents","volume":"49","author":"Merikangas","year":"2010","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1186\/s40337-023-00801-3","article-title":"Eating disorder outcomes: Findings from a rapid review of over a decade of research","volume":"11","author":"Miskovic-Wheatley","year":"2023","journal-title":"J Eat Disord"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/nu16244418","article-title":"A narrative review on the neurocognitive profiles in eating disorders and higher weight individuals: Insights for targeted interventions","volume":"16","author":"Krug","year":"2024","journal-title":"Nutrients"},{"key":"B6","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1080\/15622975.2023.2179663","article-title":"World Federation of Societies of Biological Psychiatry (WFSBP) guidelines update 2023 on the pharmacological treatment of eating disorders","volume":"24","author":"Himmerich","year":"2023","journal-title":"World J Biol Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10123167","article-title":"Antipsychotics in the treatment of children and adolescents with anorexia nervosa: A systematic review","volume":"10","author":"Pruccoli","year":"2022","journal-title":"Biomedicines"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1002\/erv.3060","article-title":"Olanzapine for young people with anorexia nervosa (OPEN): Results of a feasibility study","volume":"32","author":"Said","year":"2024","journal-title":"Eur Eat Disord Rev"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2018.18101125","article-title":"Olanzapine versus placebo in adult outpatients with anorexia nervosa: A randomized clinical trial","volume":"176","author":"Attia","year":"2019","journal-title":"Am J Psychiatry"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2025.0013","article-title":"Utility of aripiprazole in the treatment of anorexia nervosa in children and adolescents: A retrospective matched cohort study","volume":"35","author":"Bindseil","year":"2025","journal-title":"J Child Adolesc Psychopharmacol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1002\/eat.22173","article-title":"Dronabinol in severe, enduring anorexia nervosa: A randomized controlled trial","volume":"47","author":"Andries","year":"2014","journal-title":"Int J Eat Disord"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.22.2605","article-title":"Fluoxetine after weight restoration in anorexia nervosa: A randomized controlled trial","volume":"295","author":"Walsh","year":"2006","journal-title":"JAMA"},{"key":"B13","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1186\/s40337-023-00833-9","article-title":"Pharmacotherapy, alternative and adjunctive therapies for eating disorders: Findings from a rapid review","volume":"11","author":"Rodan","year":"2023","journal-title":"J Eat Disord"},{"key":"B14","first-page":"45","article-title":"Guideline on psychopharmacology for anorexia nervosa","volume-title":"Annotated clinical guidelines for eating disorders","year":"2024"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/erv.70008","article-title":"The efficacy of pharmacological treatment of depression in anorexia nervosa and underweight patients: A systematic review","volume":"34","author":"Besjes","year":"2025","journal-title":"Eur Eat Disord Rev"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.rcpeng.2022.08.007","article-title":"Efficacy and safety of antipsychotics and antidepressants in the treatment of anorexia nervosa: A systematic review","volume":"51","author":"M\u00e1rquez","year":"2021","journal-title":"Rev Colomb Psiquiatr (Engl Ed)"},{"key":"B17","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1186\/s40337-023-00941-6","article-title":"Atypical antipsychotic use does not impact weight gain for individuals with extreme anorexia nervosa: A retrospective case-control study","volume":"11","author":"Bauschka","year":"2023","journal-title":"J Eat Disord"},{"key":"B18","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1007\/s40519-024-01665-5","article-title":"Inpatient treatments for adults with anorexia nervosa: A systematic review of the literature","volume":"29","author":"Toppino","year":"2024","journal-title":"Eat Weight Disord"},{"key":"B19","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/S0165-0327(01)00432-3","article-title":"The Stanley Foundation bipolar treatment outcome network. II. Demographics and illness characteristics of the first 261 patients","volume":"67","author":"Suppes","year":"2001","journal-title":"J Affect Disord"},{"key":"B20","volume-title":"R: A language and environment for statistical computing","year":"2025"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24468","article-title":"Integrating artificial intelligence and smartphone technology to enhance personalized assessment and treatment for eating disorders","volume":"58","author":"Linardon","year":"2025","journal-title":"Int J Eat Disord"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1055\/a-2156-5667","article-title":"Longitudinal digital mood charting in bipolar disorder: Experiences with ChronoRecord over 20 years","volume":"56","author":"Bauer","year":"2023","journal-title":"Pharmacopsychiatry"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2017.238","article-title":"The new news about lithium: An underutilized treatment in the United States","volume":"43","author":"Post","year":"2018","journal-title":"Neuropsychopharmacology"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2010.0131","article-title":"Olanzapine use for the adjunctive treatment of adolescents with anorexia nervosa","volume":"21","author":"Norris","year":"2011","journal-title":"J Child Adolesc Psychopharmacol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20133","article-title":"Pharmacologic treatment of anorexia nervosa: Where do we go from here","volume":"50","author":"Attia","year":"2017","journal-title":"Int J Eat Disord"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003391","article-title":"Antidepressants versus placebo for people with bulimia nervosa","volume":"2003","author":"Bacaltchuk","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.08.070","article-title":"The comorbidity of eating disorders in bipolar disorder and associated clinical correlates characterized by emotion dysregulation and impulsivity: A systematic review","volume":"259","author":"McDonald","year":"2019","journal-title":"J Affect Disord"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20343","article-title":"Treatment of bulimia nervosa: Where are we and where are we going","volume":"46","author":"Mitchell","year":"2013","journal-title":"Int J Eat Disord"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820020059008","article-title":"Fluoxetine in the treatment of bulimia nervosa: A multicenter, placebo-controlled, double-blind trial","volume":"49","year":"1992","journal-title":"Arch Gen Psychiatry"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1016\/j.physbeh.2015.04.007","article-title":"Anorexia nervosa as a motivated behavior: Relevance of anxiety, stress, fear, and learning","volume":"152","author":"Guarda","year":"2015","journal-title":"Physiol Behav"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1750187\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T07:20:25Z","timestamp":1769412025000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1750187\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,26]]},"references-count":30,"alternative-id":["10.3389\/fpsyt.2026.1750187"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1750187","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,26]]},"article-number":"1750187"}}