Anorexia nervosa (AN) is severe and debilitating psychiatric illness characterized by destructive weight loss behaviour, refusal to maintain body weight at or above minimal normal weight for age and height, intense fear of weight gain and disturbance in experience of body shape and weight.

The purpose of this review is to investigate the state of art concerning the use of atypical antipsychotics (SGA) in the treatment of anorexia nervosa, comparing the efficacy and tolerability in female patients not selected by age.

A Medline enquiry of published articles from 2005 to October 2015 was performed using the following Keywords: “anorexia nervosa; pharmacological treatment; atypical antipsychotics; olanzapine; risperidone; paliperidone; aripiprazole; quetiapine”. Reviews and RCT were also analyzed.

No strong evidence of beneficial effects was found in using SGA in adults. The majority of studies focused on olanzapine, which seems to have, in some studies, only positive effect on body mass index, eating disorder symptoms and functional impairment. Risperidone doesn’t seem to have effect on body mass index. Olanzapine and risperidone increase the mean fasting glucose and insulin levels. In a recent study the main finding is represented by the positive effects of the adjunct of aripiprazole to antidepressants on eating-related obsessive-compulsive symptomatology.

In conclusion, in our review we observed that research in treatment with SGA of AN is still far away from finding univocal conclusions.

The authors have not supplied their declaration of competing interest.