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Cariprazine for treating coprophagia and organic psychosis in a young woman with acquired brain injury
  1. Emma Collison-Ani1,
  2. Anissa Faher2,
  3. Marcus Au2 and
  4. Gayathri Burrah1
  1. 1Neuropsychiatry Division, St Andrew's Healthcare, Northampton, UK
  2. 2University of Cambridge medical school, University of Cambridge, Cambridge, UK
  1. Correspondence to Dr Emma Collison-Ani; emma_collisonani{at}yahoo.co.uk

Abstract

Coprophagia or the ingestion of faeces has been associated with medical conditions (seizure disorders, cerebral atrophy and tumours) and psychiatric disorders (intellectual disability, alcoholism, depression, obsessive compulsive disorder, schizophrenia, fetishes, delirium and dementia). The case of a woman in her 30s presenting with coprophagia and psychotic symptoms following hypoxic brain injury is reported. The case is discussed and literature is reviewed. We investigate cariprazine, a relatively new atypical antipsychotic for treating coprophagia, associated with psychotic symptoms. Psychiatric evaluation revealed cognitive dysfunction and psychotic symptoms. Physical examination and laboratory evaluation were unremarkable. She was treated with haloperidol resulting in resolution of coprophagia. Attempts at switching to alternative antipsychotics, due to side effects, resulted in recurrence of coprophagia. Subsequent relapses required higher doses of haloperidol for remission of coprophagia and psychotic symptoms. She finally responded to cariprazine. While firm conclusions are not possible from the experience of a single case, we suggest cariprazine may also be a treatment option for coprophagia, particularly in patients with psychotic symptoms.

  • Drugs: psychiatry
  • Psychotic disorders (incl schizophrenia)

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Footnotes

  • Contributors All authors were involved in the conceptualisation and design of the report. EC-A prepared, summarised and wrote the case report. AF and MA conducted and prepared the literature review. GB was involved in supervision, drafting and revision of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.