[Organic personality disorder: response to carbamazepine]

Organic Personality Disorder is a clinical diagnosis included in ICD-10 classification and also, under a different name, in DSM-IV. Many different treatments have been proposed to improve this condition, carbamazepine being one of them. A case report is presented of a 28 years old patient who, six years before, had suffered a severe brain injury in a car accident. From then on, an intensification of previous personality traits could be observed besides sexual exhibitionism, promiscuity, aggressive episodes, suspiciousness and low impulse control. A chaotic socio-familial situation induced two psychiatric admissions. The patient was initially treated with neuroleptics, benzodiazepines and antidepressants, with no response. Treatment with carbamazepine was then started, reaching a dose of 1,200 mg/day and maintaining plasma levels of 8.8 mcg/ml. After two months of this treatment a marked improvement was observed with absence of exhibitionistic behavior and aggressive episodes, a tendency towards normalization of mood and anxiety, stabilization of his social and family relationships and starting some paid work.