Venlafaxine, an antidepressant belongs to Serotonin Norepinephrine Reuptake Inhibitors (SNRI), blocks the synaptic reuptake of serotonin in lower doses and also blocks reuptake of norepinephrine in higher doses. In addition it also blocks dopamine reuptake in still higher doses. This last mechanism of action is found to cause psychotic symptoms. Very few cases are reported with this adverse effect of venlafaxine. Here is a case report where a 32 year-old male with social phobia developed delusions of persecution on two occasions when he was put on venlafaxine 150 mg/day, which responded to withdrawal of venlafaxine and a short course of antipsychotics. The delusions never reappeared when he was maintained on escitalopram.

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Various psychiatric symptoms have been reported in patients with acromegaly. Most of them are personality changes characterized by lack of initiative and spontaneity. There are few case reports of the presence of auditory and visual hallucinations, and delusions in patients with acromegaly. We report a patient with acromegaly who had psychotic symptoms including Schneiderian first-rank symptoms.

Objective: Alcohol is one of the commonest psychoactive substances consumed globally. There are evidences suggesting its role in causing thyroid abnormality. It has been reported to have multiple effects on the hypothalamopituitary-thyroid axis. This study aimed to look at the thyroid function abnormalities in admitted male patients with alcohol dependence syndrome. Methods: Thyroid function parameters were compared among 30 male in-patients with Alcohol dependence syndrome (ADS) and 30 male in-patients with psychotic disorders as controls. Results: 23.3% of patients in the alcohol dependence group had thyroid stimulating hormone (TSH) abnormality compared to 3.3% among control (psychotic disorders) group. 23.3% in the ADS group and 10% of the control group had free T4 (FT4) abnormality. TSH abnormality was seen more in individuals whose age of onset of alcohol use was 20-30 years which was statically significant (p=0.01). TSH abnormality was noted more in patients who consumed alcohol for more than 15 years and with quantity exceeding>720 ml.