Manic Episode Precipitated by Withdrawal of Hormone Replacement Therapy in Severe Hypothyroidism

Khaldi, Slim; Dan, Bernard; Basiaux, P.; Nutte, N. De; Kornreich, Charles; Gorman, Jack M.

doi:10.1097/00131746-200611000-00010

Cited by 1 publication

(1 citation statement)

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“…In all instances thyroid supplementation was also employed for management in acute as well as maintenance phases [8 -17] . Interestingly, in 5 out of 10 reports the patients had no previous psychiatric history [8, 10 -12, 16] and in 4 out of these 5, discharge and outpatient medications consisted only of thyroid replacement [8,10,11,16] . One might contend that this supports a possible direct causal link between the manic episode and thyroid dysfunction in these individuals.…”

Section: Case Report 3 ▼mentioning

confidence: 99%

Primary Hypothyroidism Associated with Acute Mania: Case Series and Literature Review

Khemka

Ali²,

Koch³

2011

Exp Clin Endocrinol Diabetes

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In the evaluation of patients presenting with altered mental function searching for underlying medical conditions is necessary. Abnormal thyroid function has long been implicated in mood changes with the classic associations of depression occurring together with hypothyroidism and of mania along with hyperthyroidism. We here report 3 patients who presented with symptoms consistent with acute manic episode diagnosed using DSM IV-TR criteria and who were found to have primary hypothyroidism biochemically. This led to a review of the literature on this phenomenon resulting in the identification of 10 reports of mania and associated thyroid profiles consistent with primary hypothyroidism. All 3 of our patients improved clinically after use of levothyroxine and psychotropic medications, consistent with the literature reports. This illustrates that thyroid function abnormalities including primary hypothyroidism should be considered and screened for when evaluating patients with acute manic episodes.

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Section: Case Report 3 ▼mentioning

confidence: 99%