A case report on treatment of bipolar disorder in Late Onset Tay-Sachs disease

Late Onset Tay-Sachs Disease (LOTS) is an autosomal recessive genetic neurodegenerative condition that is associated with neurologic symptoms such as incoordination, imbalance, tremor, dysarthria, and cognitive decline. It is known that those with this genetic condition have an increased risk of severe mental illness including Bipolar Spectrum Affective Disorder (BPAD). However, there is limited evidence for which medications are effective in treating psychiatric illness in these people without causing worsening neurologic symptoms. We present the case of a young woman who presented with rapid mood cycling following a recent diagnosis of LOTS. We show that this patient was safely and effectively treated with Olanzapine and Lithium with return to her mental health baseline, no worsening of neurological symptoms, and continued stability at 5 months follow-up.