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thyrotoxic psychosis

Danielle Golub, Victor Rodack
OBJECTIVES: Hyperthyroidism has been associated with relatively rare presentations of psychotic symptoms. We report an example of the successful use of antipsychotics to manage psychotic symptoms in hyperthyroid-related psychosis. Furthermore, we systematically describe the available literature on the use of antipsychotics in this setting to determine the associated relative efficacies of the various antipsychotic agents. METHODS: Presentation of a case of hyperthyroid-related psychosis treated with an antipsychotic agent followed by a systematic review of all similar cases: PubMed, Ovid MEDLINE and PMC were searched for articles published between 1960 and 2017 that report on the use of specific antipsychotics in the management of hyperthyroid-related psychosis...
March 27, 2018: Neuro Endocrinology Letters
Shunsuke Kikuchi, Toshiyasu Ogata, Jiro Fukae, Jun Tsugawa, Shinji Ouma, Makito Tanabe, Toshihiko Yanase, Yoshio Tsuboi
A 57-year-old female developed dizziness and forgetfulness several days before admission. She was admitted to our hospital because of a headache and nausea. On admission, she had a mild disturbance of consciousness and right hemiparesis. Initial MR imaging revealed multiple infarctions in the acute-to-subacute phases in the right cerebellum, left occipital lobe, and bilateral parietal lobes. Her electrocardiogram showed atrial fibrillation and transesophageal echocardiography revealed the presence of a thrombus at the left atrial appendage, suggesting that she suffered from cardioembolic stroke...
December 2014: Brain and Nerve, Shinkei Kenkyū No Shinpo
Murat Emul, Ayse Sakalli, Turgut Can Erol, Turan Ertan
Thyrotoxic patients may occasionally present with affective disorders. Here, we discuss a case of a 61-year-old woman with misidentification and persecutory delusions, olfactory hallucinations, and apathy associated with thyrotoxicosis. After definitive antithyroid and antipsychotic agent haloperidol treatments, the patient was released within 4 weeks. Thyrotoxic psychosis with apathy is a rare entity that can be misdiagnosed as affective psychosis. Haloperidol may be an alternative treatment in resolving psychotic features beside the treatment of hyperthyroid state...
March 2013: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
Nobuyuki Kobayashi, Junichi Tajiri, Masahiro Takano
INTRODUCTION: There are few reports on thyrotoxic psychosis caused by diseases other than Graves' disease or toxic nodular goiter. CASE PRESENTATION: A 64-year-old Japanese woman was treated for anxiety disorder in our clinic for 10 years. She had five episodes of transient psychosis during the first five years. When she developed psychosis without neck pain 10 years after her first visit, a laboratory reexamination revealed that she had subclinical hyperthyroidism, and tested positive for antithyroid autoantibodies, negative for thyroid stimulating hormone receptor antibody and had decreased radioactive iodine uptake...
2011: Journal of Medical Case Reports
Bushra Abbasi, Zain Sharif, Laurie R Sprabery
Thyrotoxic periodic paralysis is a rare and potentially lethal neuromuscular disease that manifests as recurrent episodic muscle weakness associated with hypokalemia and thyrotoxicosis. Paralysis can rarely involve respiratory muscles leading to acute respiratory failure. The disease primarily affects people of Asian descent, but it is being increasingly reported in other ethnic groups. We review the literature and report a case of hypokalemic thyrotoxic periodic paralysis manifesting as thyroid storm with episodic acute respiratory failure requiring recurrent intubation and eventually requiring thyroidectomy for resolution of symptoms...
August 2010: American Journal of the Medical Sciences
Johan Malm, Mathias Färnegârdh, Gary J Grover, Paul W Ladenson
Thyroid hormone receptors (TRs) exert profound effects on development, metabolism, and multiple specific organ functions. Principally by regulating crucial genes in a variety of tissues, the thyroid hormones, 3,5,3'-triiodo-L-thyronine (L-T(3), 1) and 3,5,3',5'-tetraiodo-L-thyronine (L-T(4), 2), influence basal calorigenesis and oxygen consumption, cardiac rate and contractility, lipid metabolism, bone structure and strength, and central nervous system functions critical for normal mentation and mood. Elevated levels of circulating and tissue 1 and/or 2 result in the thyrotoxic clinical state, manifested by weight loss despite increased caloric intake; heat intolerance due to increased calorigenesis; cardiac tachyarrhythmias, systolic hypertension, and heart failure; skeletal muscle weakness; and a spectrum of neuropsychiatric symptoms ranging from anxiety to delirium and psychosis...
2009: Current Medicinal Chemistry
Ali A Rizvi
Severe psychiatric derangements are a rare manifestation of Graves disease or toxic goiter. An 18-year-old male college student was hospitalized with depression and psychotic behavior. He was found to have thyrotoxicosis due to subacute thyroiditis, as evidenced by a reduced radioactive iodine uptake, elevated thyroglobulin level, and spontaneous remission into a hypothyroid phase. His behavioral abnormalities resolved with progressive normalization of thyroid function. To our knowledge, this is the first reported case of the self-limited condition of subacute thyroiditis causing 'thyrotoxic psychosis' and serves to remind clinicians of this association when treating patients in clinical practice...
August 2007: Southern Medical Journal
Zsuzsa Aszalós
Thyroid hormones are of primary importance for the perinatal development of the central nervous system, and for normal function of the adult brain. These hormones primarily regulate the transcription of specific target genes. They increase the cortical serotonergic neurotransmission, and play an important role in regulating central noradrenergic and GABA function. Thyroid deficiency during the perinatal period results in mental retardation. Hypothyroidism of the adults causes most frequently dementia and depression...
February 18, 2007: Orvosi Hetilap
B Ortega Calonge, J Simón llanes, F Moruno Arena, A Labad Alquézar
The first step in the assessment of a patient who presents psychiatric symptoms is to discard somatic illness. We present a case of a patient whose symptoms began with confusion, behavior alterations and agitation, which were followed by psychomotor inhibition with visual hallucinations, with underlying thyrotoxicosis. In the discussion, we analyze the aspects to consider in order to detect similar cases and their treatment, since, although it is a rare form of presentation of hyperthyroidism, it should be taken into account due to the seriousness of the picture...
January 2004: Actas Españolas de Psiquiatría
No abstract text is available yet for this article.
December 14, 1950: Ugeskrift for Laeger
B E Brownlie, A M Rae, J W Walshe, J E Wells
OBJECTIVE: To report a series of newly diagnosed thyrotoxic patients with concurrent acute psychosis, and to assess the association between the two disorders. DESIGN: Retrospective study of thyrotoxic patients with associated psychosis ('thyrotoxic psychosis'; TP) requiring inpatient psychiatric care. New Zealand thyrotoxicosis annual incidence figures and first psychiatric admission rates for affective psychosis were utilised to statistically assess the co-occurrence of thyrotoxicosis and affective psychosis...
May 2000: European Journal of Endocrinology
Y Nagai, K Ohsawa, T Hayakawa, T Abe, T Sawada, K Nakajima, Y Hashizume, K Kobayashi
We present a patient with Cushing's syndrome due to adrenocortical adenoma who developed acute adrenal insufficiency one month after unilateral adrenalectomy. She had received lithium carbonate for five years for manic-depressive psychosis. Drug administration was interrupted for 2 weeks postoperatively and was resumed thereafter. At the adrenal crisis, her serum free T4 and T3 levels were both high and serum TSH was subnormal. The thyrotoxicosis subsided spontaneously within 2 weeks. Serum thyroglobulin was markedly increased during the thyrotoxic state...
April 1994: Endocrine Journal
A Lazarus, R Jaffe
Psychoses due to thyrotoxicosis are typically affective in nature. We report on a schizophreniform psychosis in a woman with Graves' disease whose symptoms abated following subtotal thyroidectomy. Surgical thyroidectomy should be considered in thyrotoxic patients who are unresponsive to medical therapy or who manifest unremitting or life-threatening psychotic behavior, especially if long-term compliance required for medical therapy appears unlikely.
January 1986: General Hospital Psychiatry
L Schaaf, M Greschner, R Paschke, K Kusterer, J Teuber, K Huck, R Schmidt, H D Säger, K H Usadel
Thyrotoxic crisis (thyroid storm) is a rare complication of hyperthyroidism. It can be observed not only in thyroid autonomy with latent hyperfunction after exposure to iodine, but also in Graves' disease with overt hyperfunction. Adequate management of thyrotoxic crisis is still controversial. We report about four patients (four women, mean age 75 years) with Graves' disease who developed thyrotoxic crisis during therapy with antithyroid drugs so that surgical intervention became necessary. The patients had been admitted to the hospital for nonspecific symptoms such as headache, cachexy, and psychosis...
November 9, 1990: Klinische Wochenschrift
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