Effectiveness and safety of atypical antipsychotic treatment in children and adolescents with avoidant/restrictive food intake disorder
Authors: Mosheva Mariela , Sela Yaron , Arad-Rubinshtein Shani , Serur Yaffa , Omer Ganit , Hertz-Palmor Nimrod , Gothelf Doron , Stein Daniel 
Published: June 2024

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Introduction: Avoidant restrictive food intake disorder (ARFID) is a childhood feeding and eating disorder often associated with marked physical and psychosocial impairment.
Objective: We assessed the efficacy and safety of atypical antipsychotic (AAP) medications in promoting weight and height gain in children with ARFID.
Methods: The computerized medical records of 21 children with ARFID (mean age 10.54 ±3.21 years) receiving AAPs in one center in Israel were retrospectively reviewed. These children were after 6.30±0.75 months of no weight gain with treatment as usual (TAU) and then were treated for 18 months with AAPs. Weight and height were extracted from the medial records at eight time points; improvement based on the Clinical Global Impression scale (CGI) and adverse events were also recorded.
Results: A significant increase was found in weight, height, and body mass index (BMI) over 18 months of treatment with AAPs (Δweight: 9.66±9.24 kg, p<0.001; Δheight: 10.23±, p<0.001; ΔBMI=2.55±1.53 kg/m2; p<0.001). Weight increased significantly for both sexes, while height increased significantly only for boys. Patients with both low and high baseline BMI percentiles gained weight, while mean height increased significantly over time only for children with low BMI percentile. The use of a retrospective CGI assessment indicated a marked improvement in the children’s clinical condition over time. Adverse effects were minimal, and no patients discontinued AAP due to adverse events.
11.54 cm
Conclusion: The addition of AAPs for a period of 18 months is safe and effective in increasing weight, height and BMI in children with ARFID previously unresponsive to TAU.