Pica – Mind over matter: a case report

Abstract

The geneses, treatment and outcome of pica remains the subject of much debate. Data regarding pica in adults and in schizophrenia is limited. We present the case of a forty-year old male who presented with subacute intestinal obstruction. Having met the diagnostic criteria for schizophrenia, he subsequently developed symptoms which enabled a diagnosis of pica. Initially the pica symptoms were as a response to the command hallucinations, but later persisted in the absence of hallucinations. Pica can be potentially life-threatening, depending on the substance ingested and the complications that follow, as was the case in this patient. Risperidone, olanzapine or electro convulsive therapy did not have any impact on his symptoms of pica. Clozapine was commenced and a dramatic response was observed, with the pica symptoms completely resolving within 10 days – thus revealing a new facet to the already versatile therapeutic effects of clozapine.