Two Cases of Olfactory Reference Syndrome Treated with Risperidone

Olfactory reference syndrome (ORS) is a rare psychiatric condition severely affecting quality of life and global functioning of affected subjects. Despite its peculiar clinical pattern, its classification as independent entity rather than as delusional disorder or general medical manifestation of neurological diseases, is still debated and far from to be clarified. Indeed, if classifying ORS as a type of delusional disorder according to DSM-5 seems problematic, its inclusion in obsessive-compulsive related disorders seems to be more promising from both a psychopathological and a management point of view. Nevertheless, ORS exhibits an inadequate response to antidepressants and psychotherapy, with increased sensitivity for second generation antipsychotics. As a result, its definition, clinical diagnosis, and adequate treatment management are missing, leading to a poorly evidence-based approach to the topic. Here, we present two ORS cases successfully treated with risperidone after several previous treatment attempts. We aim to spread knowledge about this rare but severe disorder to improve clinicians’ awareness adding evidence to the current poor literature available on the topic.

Cite this article as: Reddy B, Nocera A, de Filippis R, Das S. Two cases of olfactory reference syndrome treated with risperidone. Neuropsychiatr Invest. 2022;60(2):49-51.