# Outcomes of Anorexia Nervosa in a Male Patient Treated With Paroxetine: A Case Report

## TL;DR

A 15-year-old boy with anorexia nervosa and obsessive-compulsive symptoms showed significant improvement after being treated with paroxetine.

## Contribution

This case report highlights the effectiveness of paroxetine in treating anorexia nervosa in a male patient.

## Key findings

- The patient showed significant physical and mental improvement after switching from fluoxetine to paroxetine.
- The patient had a history of multiple hospitalizations due to severe complications from anorexia nervosa.
- Paroxetine was found to be more effective in this case compared to previous treatments like olanzapine and fluoxetine.

## Abstract

Eating disorders (EDs) are among the most dangerous mental illnesses, that are characterized by high mortality rates, multisystem comorbidity, and an often chronic and relapsing disease course. EDs occur most commonly in the female gender, with a ratio of 10 females to 1 male for anorexia nervosa (AN). We present the case of a 15-year-old Saudi boy who presented with weight loss (BMI 11.6 kg/m2) and began to have symptoms of obsessive-compulsive disorder (OCD) in prayer and ablution. His first treatment plan was psychoeducation. He then developed a fear of gaining weight and began to count calories; he was diagnosed with AN and started on olanzapine 2.5 mg. The patient had a history of multiple admissions due to electrolyte imbalance, hypokalemia, hypoglycemia, and anal fissure due to constipation, and was prescribed olanzapine 5 mg, fluoxetine 20. His last admission was the worst, as he became semi-comatose with a Glasgow Coma Scale (GCS) of 13, was diffused and disoriented to time and person, unable to walk or sit, and was uncooperative in answering questions. During admission, we changed the fluoxetine to paroxetine 25 mg and increased the olanzapine to 10 mg, and the patient showed a huge improvement physically and mentally. This case emphasizes the significance of including paroxetine in the treatment of diagnoses for AN to prevent unnecessary wasting of time and effort.