Rosh Psychiatry Board Practice Exam

Which medication is most likely to aid in weight gain for a patient diagnosed with anorexia nervosa?

1. Clomipramine

2. Fluoxetine

3. Olanzapine

4. Venlafaxine

The correct answer is: Olanzapine

Olanzapine is an atypical antipsychotic that has been shown to support weight gain in patients with anorexia nervosa. One of the recognized side effects of olanzapine is the potential for weight gain due to its effects on appetite stimulation and metabolic changes. This medication is sometimes used in the treatment of anorexia nervosa, particularly when there are coexisting symptoms of anxiety or mood disorders, as it can also help stabilize mood and reduce anxiety, which may indirectly contribute to a patient’s willingness and ability to eat. In contrast, medications like fluoxetine, while they may be used to address symptoms of depression or anxiety in patients with anorexia nervosa, have not been shown to promote weight gain effectively and can even have a weight-neutral or weight-losing effect in some patients. Similarly, venlafaxine is an antidepressant that generally does not promote weight gain and can sometimes be associated with weight loss. Clomipramine, a tricyclic antidepressant, can have variable effects on weight, but it is not primarily recognized for inducing weight gain and is not a first-line treatment for anorexia nervosa. Therefore, olanzapine stands out as the most appropriate option for aiding weight gain in an individual