Case Report

The Pathophysiology and Management of Coprophagia: A Report of Two Cases and Literature Review

Table 2

Review of selected literature on the management and outcomes of coprophagia.

Article TreatmentOutcome of TreatmentHow long for the coprophagic behavior to respond

Coprophagia in an 8-Year-Old Hospitalized Patient: A Case Report and Review of the Literature. Bacewicz, et al., 2017. [9]1:1 observation and psychiatry consult. Outpatient psychiatric services after dismissionCoprophagic behavior ceasedImmediately after the 1:1 observation

Coprophagia in an elderly man: a case report and review of the literature. Beck, et al., 2005. [5]Sertraline 25 mg dailyCoprophagic behavior ceased

Coprophagic cafè coronary. Byard, et al., 2001. [11]Not applicableNot applicableNot applicable

A case of coprophagia presenting with sialadenitis. Donnellan, et al., 1999. [12]AntibioticsCoprophagic behavior ceased

Coprophagic Asphyxation in an Intellectually Disabled Woman. Erickson, et al., 2017. [13]Not applicableNot applicableNot applicable

Treatment of a retarded child’s faeces smearing and coprophagic behaviour. Friedin, et al., 1979. [14]Toilet trainingCoprophagic behavior reduced8 months

A clinical study of adult coprophagics. Ghaziuddin, et al., 1985. [15]Not discussedNot discussedNot discussed

Coprophagia in neurologic disorders. Josephs, et al., 2016. [1]Behavioral treatment (mittens and behavioral modification technique), Haloperidol, Lorazepam, Citalopram, Trazodone, Mirtazapine, Valproic Acid, QuetiapineCoprophagic behavior ceased only when used Haloperidol was used (1-3 mg daily)

Coprophagia and urodipsia in a chronic mentally ill woman. McGee, et al., 1989. [4]Reproductive and rewarding activities (sewing, art group, music appreciation group)Coprophagic behavior ceased6 weeks

Aripripazole treatment for coprophagia in autistic disorder. Pardini, et al., 2010. [3]Aripripazole (15 mg daily)Coprophagic behavior reduced substantially8 weeks

Coprophagia and pica in individuals with mild to moderate dementia and mixed (iron deficiency and microcytic) anemia. Sharma, et al., 2011. [2]behavioral changes, including antecedent manipulation, discrimination training between edible and nonedible items, self-protection devices that prohibit placement of objects in the mouth, sensory reinforcement, differential reinforcement of incompatible behaviors such as screening (covering eyes briefly), contingent aversive oral taste (lemon), contingent aversive smell sensation (ammonia), contingent aversive physical sensation (water mist), brief physical restraint, and overcorrection (correct the environment or practice appropriate alternative responses). Donepezil 10 mg daily, Memantine 5 mg twice daily, Ziprasidone 40 mg at bedtime, Duloxetine 90 mg daily, and Mirtazapine 15 mg daily (medication that was administered before the coprophagic behavior)Patient improved

Treatment of coprophagia with carbamazepine. Stewart, 1995. [7]Carbamazepine regimen titrated to a maximum dose of 300 mg tid, Phenytoin 100 mg bid, Dexamethasone 2 mg tid, LorazepamCoprophagic behavior ceased only with Carbamazepine

Escalation of a fetish: coprophagia in a nonpsychotic adult of normal intelligence. Wise, et al., 1995. [10]Supportive psychotherapy and tricyclic antidepressant, alcoholics anonymous meetingsCoprophagic behavior ceased22 months