olanzapine and Calcinosis

Fahr disease, also known as familial idiopathic basal ganglia calcification, is a rare neurodegenerative disorder, the etiology of which remains unknown. Given its various presentations, Fahr disease is presumed to be underdiagnosed and its prevalence underestimated. We present a case of Fahr disease that presented mainly with pure psychiatric symptoms. Isolated psychiatric symptoms without neurological manifestations are rarely seen in patients diagnosed with Fahr disease. Psychiatrists should consider Fahr disease as a differential diagnosis in the evaluation of psychiatric illness.

Topics: Basal Ganglia; Basal Ganglia Diseases; Calcinosis; Depression; Diagnosis, Differential; Female; Humans; Mental Disorders; Middle Aged; Neurodegenerative Diseases; Olanzapine; Paroxetine; Psychiatric Status Rating Scales; Psychotropic Drugs; Tomography, X-Ray Computed; Treatment Outcome

Topics: Adult; Antipsychotic Agents; Basal Ganglia Diseases; Benzodiazepines; Brain; Calcinosis; Capgras Syndrome; Female; Humans; Olanzapine; Tomography, X-Ray Computed; Treatment Outcome

This report describes the case of a young man with a large calcification in the right thalamus that was first diagnosed at 9 years of age. Case history reveals specific eating rituals and other obsessive-compulsive personality traits during the patient's childhood and adolescence, fulfilling diagnostic criteria of obsessive-compulsive personality disorder. After a critical life event the patient develops anorexia nervosa. We suggest that our case and further literature provide evidence for an involvement of specific thalamic structures, such as the dorsomedial nucleus, in the development of anorexia nervosa. Furthermore, the treatment of the patient by a combined psychotherapeutic and pharmacotherapeutic approach is described. We focus on the beneficial effect of the atypical antipsychotic olanzapine, which can induce weight gain by an increase of leptin levels.

Topics: Adult; Anorexia Nervosa; Benzodiazepines; Calcinosis; Combined Modality Therapy; Dominance, Cerebral; Humans; Life Change Events; Male; Mediodorsal Thalamic Nucleus; Mianserin; Mirtazapine; Obsessive-Compulsive Disorder; Olanzapine; Paroxetine; Psychotherapy; Thalamic Diseases; Tomography, X-Ray Computed