.png)
Huntington’s disease is a neurodegenerative disease, which is caused by autosomal dominant mutation. Underlying cause is a mutation of IT15 gene, which is located on short arm of Chromosome 4. The mutation leads to expansion of CAG trinucleotide repeat. On cranial imaging, neuronal loss is particularly remarkable in striatum. Symptoms usually occur at age of 30-50 years and rapidly progress. At baseline, the disease is characterized with motor symptoms, such as chorea and dystonia, psychiatric symptoms and progressive dementia. Common psychiatric symptoms of Huntington’s disease include depression, irritability, anxiety disorders, obsessive behavior, suicide thoughts and behavior and personality changes. Psychosis is relatively rare. Here, a patient is present, who has Huntington’s disease, which is associated with psychotic symptoms. A 71-year-old male patient. Patient is followed up for 25 years for Huntington’s disease. Patient is taking tetrabenazine to treat involuntary movements. Complaints of bad temper, aggressiveness and refusal of eating developed 6 months ago, when the patient thought that relatives were attempting to poison him. Sleep quality decreased. On psychiatric assessment, patient is conscious, cooperating and oriented. Speech is dysarthric. Affection is agitated. Persecutory delusions are noted in thought content. Patient was specifying visual perception defects. Finding of dementia could not be noted. Patient was started on olanzapine at dose of 5 mg/day. Agitations regressed, as observed in control visits. Persecutory delusions and auditory hallucinations disappeared. Although rare, psychotic symptoms can be seen in Huntington’s disease, resulting impair the patient’s compliance. Neuroleptic treatment will be required when psychotic symptoms occur. However, atypical neuroleptic agents should be preerred and patient is frequently controlled since typical neuroleptic agents aggravate dystonia and involuntary movements, which are secondary to Huntington’s disease.