She reported intense cravings and ate clay multiple times/day, which continued for the next month before a spontaneous resolution. After a 24-year interval, however, she again started experiencing an irresistible urge to eat clay within 10 days of the start of olanzapine treatment. Later on, during the first trimester of pregnancy (aged 20 years), she had developed a desire to eat raw clay, which had ceased after the first trimester. She had a past history of eating chalk-powder during her childhood (aged < 10 years). In the past, she had received low doses of atypical antipsychotic drugs for 1–3 months maximum (including olanzapine at 5 mg/day) with highly erratic compliance. She was given olanzapine (tablets) 10 mg/day. The patient's psychotic symptoms improved after a month, and she is currently asymptomatic on risperidone.Ĭase B was a 44-year-old woman with diabetes mellitus and hypothyroidism (on regular treatment) with paranoid schizophrenia (6 years) who had first presented to our clinic in July 2014. The condition gradually remitted on its own over the next 3 weeks. She ate a handful of rice multiple times/day and sometimes at night-time.
Previously, she would have occasionally taken a few rice grains while washing/cooking, but now the quantity and frequency of this habit were markedly increased. After 1–2 weeks, she developed irresistible urges to eat raw rice grains several times/day (amylophagia). She was started on risperidone (tablets), which was increased to 4 mg/day over a week. Her previous treatment records were not available. During her first visit to our clinic in July 2015, she had been off medication since 2008, with a relapse over the past year.
We report pica in two patients shortly after initiation of antipsychotic treatment.Ĭase A was a 50-year-old woman who had suffered from ‘other nonorganic psychotic disorder’ (ICD-10) for 25 years, episodic in course. Pica is the persistent intake of non-nutritional substances in a culturally non-sanctioned way.