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The successful treatment of a gender dysphoric patient with pimozide
1Department of Psychiatry, Charing Cross and Westminster Medical School, University of London, UK.
Objective:
The case is reported of a gender dysphoric patient who responded successfully to pharmacotherapy with pimozide.
Clinical Picture:
An adult male patient with a borderline learning disability presented with cross-dressing and a strong wish to undergo a sex change.
Treatment:
Supportive psychotherapy and pharmacotherapy with pimozide was tried.
Outcome:
There was an excellent response to pimozide 2 mg daily, with a cessation of both cross-dressing and the wish for sex reassignment. When, after 1 year, the dose was reduced to 1 mg daily, there was a rapid return of the cross-dressing and the wish for sex reassignment. An increase in the dose again led to a remission which has been maintained since then.
Conclusion:
Pharmacotherapy with pimozide should be considered in cases of doubtful gender dysphoria.