New drug 'loosens the hold' of anorexia nervosa

She was just 11 years old, but Rachael Manion had literally starved her self to near death. She had become morbidly underweight because of anorexia nervosa -- a disease that turned her mind into her enemy - ordering her to stop eating food. "The voice was telling me, if I looked at a piece of fruit, 'don't eat it -- it's too fatty. Look at yourself, you're so fat'." Even when Rachael was hospitalized, and hooked to a cardiac monitor because doctors feared she would have a heart attack, that voice taunted her: "Lets keep losing more weight." "This was going to kill me, basically" says the Ottawa girl. Today, she is a healthy, well-adjusted and articulate 14-year-old who eats cakes, pizza -- whatever she wants. "I eat it all," she says happily. Rachael and her mother agree that part of her recovery from anorexia is due to an anti-psychotic drug, olanzapine, that doctors say appears to break the obsessive fear of food in many anorexic patients. "It loosened the hold of the illness," Rachael, mother, Nina Chatterjee, told CTV News. "She was more receptive to therapy. She was not as angry or confrontational." Doctors who specialize in eating disorders say this could be the breakthrough they've been hoping for. About 50 per cent of anorexia patients are resistant to all kinds of therapy -- psychological, behavioral, pharmaceutical, family, nutritional, and unconventional. And between five and 20 per cent of anorexia patients die of their disease, despite use of current treatments. The new study by doctors in Canada and Australia shows that the drug, olanzapine, helped erase the obsessive worry about weight loss and food that characterizes anorexia. Dr. Laird Birmingham, head of the eating disorders program at St. Paul's Hospital in Vancouver and a co-author of the study, says this finding is "incredibly exciting." "There hasn't been any medication that has consistently helped patients with anorexia," Birmingham said. Birmingham worked on the study with researchers at the Royal Prince Alfred Hospital in Sydney, Australia. The study compared olanzapine (which is sold under the trade name Zyprexa) to another antipsychotic drug called chlorpromazine in 15 anorexic patients. All the patients in the study gained weight. But those taking the olanzapine had a marked 50 per cent reduction in obsessive thoughts about losing weight and a fear about food. "Over the last few years we have found that in people who have taken this medication, the fear has decreased enough so that they can enter treatment," Birmingham said. "Some of them are all better now and we thought none of them would ever get better, so this is an amazing discovery." Window of opportunity One of those who got better on olanzapine was Yvonne. She starved herself down to 72 pounds, began losing her vision and ended up in a hospital. Her desperate family doctor warned her that she could die within days if she lost four more pounds. "Sometimes I would go five days without touching solid food. I would survive on literally two or three cups of coffee with skim milk for five, six days at a time," Yvonne, 39, told CTV. " I remember saying to myself, 'I don't need food.'" Within days of starting the drug, Yvonne noticed that her anxiety had diminished. Eventually they went away. "It got rid of 99.9 per cent of the anorexic thoughts. It is giving me a respite from the constant battle with anorexic thoughts." Part of the problem with treating anorexia is that many patients resist therapy. Some become violent. "Patients are so resistant, and you can only help them when they're ready to help themselves," says Dr. Wendy Spettigue, an eating disorders specialist at the Children's Hospital of Eastern Ontario in Ottawa. She has been using the drug for about three years, after discovering it made patients more open to therapy. "We found the olanzapine helps decrease the anxiety, decrease the obsessions, decrease the phobia-making patients less resistant and easier to work with," Spettigue said. Up until now there have been only anecdotal reports the drug helps. Birmingham's study is the first scientific proof it may work. It was presented at a recent meeting of the Asian Pacific Eating Disorders Congress and has been submitted for publication in a medical journal. "This is the first randomized controlled trial which provides us with real proof that it seems to be effective for treating anorexia nervosa," says Spettigue. Doctors think that the olanzapine is changing chemicals in a part of the brain called the amygdala, a region that is involved in generating fear. "The key thing about this drug is that it addresses the core of the disorder -- an abnormal neurotransmission of the brain," Birmingham said. For years researchers have tried talk therapy, cognitive therapy , anti-depressants -- all in a desperate attempt to treat patients with this disorder. Still, 50 per cent of patients relapse and in the process, lose their health, jobs, family and friends. In Canada, one in 20 women between 14 and 254 suffer from anorexia. But the drug isn't a cure. Researchers say it's more like a window-of opportunity -- allowing patients to accept standard treatments. Some of the issues still to be addressed: What is the best dose and how long should patients be on it. Further studies on olanzapine will be conducted Rachael was on the drug for one year, and hasn't used it since. "The medication gave me confidence. I'm not worried about food any more."