An institutional review board approved this study, and the subjects provided written informed consent. Six subjects (50% women, mean age=29.3 years, SD=11.9) were first treated with fluoxetine for ≥12 weeks (mean dose=70.0 mg/day, SD=11.0). Olanzapine was then added to fluoxetine (the fluoxetine dose was unchanged) if the fluoxetine response was inadequate (i.e., the subjects still met DSM-IV body dysmorphic disorder criteria, had a body dysmorphic disorder score ≥20 on the Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (4), and were no more than minimally improved on the Clinical Global Impression scale [CGI]). Two subjects received olanzapine under double-blind conditions; four were treated openly with olanzapine after failing to respond to placebo. Exclusion criteria were standard for efficacy studies. The subjects took no other psychotropic medications. Olanzapine was begun at 2.5 mg/day, with an attempt to raise the dose to 15 mg/day over 8 weeks if it was tolerated.