Serotonergic and dopaminergic dysregulation as a core feature of anorexia nervosa, might be amenable to therapeutic modulation by atypical antipsychotics which encompass differing serotonergic and dopaminergic receptor affinities. There were no enough well-controlled clinical trials of antipsychotic medication in AN. Therefore, case reports seem to be of the certain help for clinicians.

Aim of the paper was to present a case of AN diagnosed with (DSM-IV) anorexia nervosa, restricting subtype, who responded well to risperidone treatment.

Psychopathology was evaluated by means of Eating Disorders Inventory (EDI-2) and Symptom Check List 90 (SCL-90-R). Patient was prescribed a starting dose of 0.5 mg/day of risperidone (baseline), with subsequent titration up to 2 mg/day during 6 weeks. Than, drug treatment was stopped.

With 6 weeks treatment on low-doses of risperidone, she started to gain weight during the next month, as well as to improve the attitudes toward eating. Moreover, normalization was evident in terms of body image alteration (BMI= 16.8); anxiety about meals was reduced; frequency of obsessive thoughts about body image decreased.

This case report suggests that the atypical antipsychotic risperidone is associated with significant improvement of AN simptomatology, We suggest that therapy with risperidone might be beneficial for severe AN. However, many questions could be raised: is it a therapy of choice, or it is a second, third or any other line of treatment; is it also beneficial considering further course of the illness; etc…