Seroquel (generic name quetiapine) is a drug under investigation for treatment of anorexia nervosa. Seroquel is classified as an atypical antipsychotic; one of its primary indications is for the treatment of schizophrenia. But like many medications prescribed to improve mental health, Seroquel has multiple uses. It is a common prescription for bipolar disorder, effective in treating symptoms of mania and depression. (For another example of a drug with multiple uses, consider the drug bupropion, which is marketed as Wellbutrin for prescription as an antidepressant and Zyban as a medication to help stop smoking.)
How Seroquel May Work Against Anorexia
In anorexia, the hope is that Seroquel will work to quiet symptoms like delusional thinking (the belief for the person with anorexia that she is still fat when drastically underweight) and social and emotional withdrawal. If these symptoms weaken, the hypothesis says, the person with anorexia may be more willing to add and retain life-giving weight. Clinicians may also prescribe Seroquel for disorganizing anxiety symptoms like those present in eating disorders, even though the drug is not labeled for that purpose.
Two small studies, both published in 2007, investigated Seroquel's usefulness in treating anorexia. One (Powers et al.) suggests that Seroquel does reduce symptoms of anorexia that overlap with symptoms of schizophrenia. It was also effective at reducing symptoms specific to anorexia: Body dissatisfaction, fears of maturity, and preoccupation with food all decreased significantly.
The second study (Bosanac et al.), working with subjects with body mass index (BMI) levels less than 15, found improvement in restrictive eating when subjects received psychotherapy in addition to the medication. It also suggested that the drug potentially could help in weight restoration, as there were significant differences in BMI over 8 weeks in the treatment group.
Is Hope for Treating Anorexia With Seroquel Premature?
Hope is a good thing at any point in research in anorexia treatment, but it's important not to assume that Seroquel is the "magic bullet." The studies conducted so far are open-label trials, which means that researchers and test subjects know when they're taking the drug. They also had very small sample sizes (under 20 test subjects in each). Given the small sample sizes of the studies, the open-label design leaves a greater chance that a high percentage of test subjects experienced good results with the drug simply because they were taking something that they thought would help (the placebo effect). They could also have felt better due to "wanting the study to go well." This is true in any research, but persons with anorexia are especially interested in pleasing others (even at great cost to themselves).
Both studies I examined acknowledge that they are only pilot studies, and that future research must include double-blind placebo-controlled trials. It's also important to note that the Bosanac study was sponsored by AstraZeneca, the maker of Seroquel.
All about SeroquelSources:
Bosanac P, Kurlender S, and Norman T. An open-label study of quetiapine in anorexia nervosa. Human Psychopharmacology: Clinical and Experimental 22 (2007): 223-230.
Kay SR, Fiszbein A, and Opler LA. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13 (1987): 261-276.
MedlinePlus. Quetiapine. Accessed 10 January 2007.
Powers PS, Bannon Y, Eubanks R, and McCormick T. Quetiapine in anorexia nervosa patients: An open label outpatient pilot study. International Journal of Eating Disorders 40 (2007): 21-26.
