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Managing Psychosis in Acute Intermittent Porphyria: A Case Report on Olanzapine Use.
Chwee Fern Ooi1, Chao Tian Tang1, Sing Qin Ting1
1Department of Psychiatry, Sengkang General Hospital, Singapore, SGP.
Cureus
|July 14, 2025
Summary
Acute intermittent porphyria (AIP) can cause acute psychosis and neurovisceral symptoms. Early diagnosis and treatment with olanzapine can effectively resolve psychiatric manifestations in AIP patients.
Area of Science:
- Neuroscience
- Genetics
- Psychiatry
Background:
- Acute intermittent porphyria (AIP) is an inherited metabolic disorder characterized by deficient porphobilinogen deaminase activity.
- AIP leads to the accumulation of neurotoxic porphyrin precursors, causing a range of symptoms including abdominal pain, autonomic dysfunction, and neuropsychiatric disturbances.
Observation:
- A 41-year-old woman with no prior psychiatric history presented with acute psychosis, including delusions and agitation, alongside severe abdominal pain and autonomic symptoms.
- Diagnostic workup revealed elevated urinary porphobilinogen, confirming AIP.
Findings:
- The patient's psychiatric symptoms, including delusions and agitation, completely resolved within eight days of treatment with olanzapine.
- Olanzapine was found to be safe and effective for managing AIP-related psychosis in this case, with no reported adverse effects.
Implications:
- This case highlights the importance of considering AIP in the differential diagnosis of acute psychosis, especially when accompanied by physical symptoms.
- Further research is needed to establish standardized treatment guidelines for neuropsychiatric manifestations of AIP, with olanzapine showing promise as a therapeutic option.
Keywords:
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