nd motivation. No proven effective treatments, including pharmacotherapy, are currently available for patients affected by AN and the difficulties in performing large-scale randomized controlled trials in this research field have been widely acknowledged. Earlier studies showed that first-generation antipsychotics should be used with caution to treat AN because of shortand long-term side effects. Nevertheless, over the last years increasing interest has been devoted to the use of atypical antipsychotics in the treatment of AN. The rationale for using atypical antipsychotics in AN is grounded on: a) the neurobiology of AN, with the alterations of dopamine and serotonin pathways in the brain; b) the antidopaminergic properties of these medications that could mitigate sufferers’ obsessional thinking towards weight and body shape; c) AA positive effects on safety, anxiety, eating psychopathology and depression; d) the increase in appetite and food intake that AA entail, consequently enhancing weight restoration, given the high-affinity profile to serotonergic, histaminergic, and adrenergic receptors. A handful of case reports and open trials described the use of quetiapine, amisulpride, and aripiprazole for adult patients diagnosed with AN. Controlled trials investigated the effectiveness of olanzapine in adult patients with AN providing mixed results with respect to weight gain but overall supporting the effectiveness of this AA on patients’ comorbid conditions like depression, anxiety, and obsessive-compulsive traits. Nevertheless, recent meta-analysis have called into question the effectiveness of AA medications, although their usefulness for subgroups of patients cannot be ruled out. In fact, the modest number of available RCTs makes it difficult to ascertain whether specific subgroups of patients might benefit from using AA and an individualized clinical judgment should guide the treatment choice. Converging evidence indicates that patients affected by AN are frequently characterized by comorbid disorders, mainly anxiety disorders, obsessive-compulsive GW 501516 disorder, and major depressive disorder. Notwithstanding this overlap and some encouraging findings, antidepressants failed to be effective in clinical trials in AN and their impact on depressive comorbidity has been recently questioned. Surprisingly, evidence is still lacking as regards the combination of SSRIs and AAs. This is noteworthy in the light of a couple of considerations. Firstly, AAs have been widely used since decades in general psychiatry as augmentation agents for severe forms of depression and obsessive features. Secondly, on one hand the PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19783938 association of different medications is common in clinical practice in AN but on the other hand such data are very difficult to quantify and report. Given the aforementioned gaps in literature, with this retrospective study we aimed to garner preliminary data on the real-world use of AAs as augmentation agents of SSRIs in AN. Our research question focused on olanzapine and aripiprazole with the former being included on the basis of PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/19784385 the aforementioned literature. Aripiprazole was selected in an exploratory fashion because of a twofold rationale: a) its beneficial effects suggested not only by our clinical experience but also by authoritative groups in the AN field; b) the dearth of data on its use in AN in spite of its efficacy on frequently reported comorbid conditions in psychiatric patients. We hypothesized that the augmentation of SSR

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