ASPOFAFF :: Journal - Volume 2 :: Volume 2 - Issue 1 :: Vol 2 - Iss 1 - Short Communication - Manic Episode Precipitated by withdrawal of substitution Hormonotherapy in severe Hypothyroidism


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ASPOFAFF :: Journal - Volume 2 :: Volume 2 - Issue 1 :: Vol 2 - Iss 1 - Short Communication - Manic Episode Precipitated by withdrawal of substitution Hormonotherapy in severe Hypothyroidism

Vol 2 - Iss 1 - Short Communication - Manic Episode Precipitated by withdrawal of substitution Hormonotherapy in severe Hypothyroidism #58

Manic Episode Precipitated by withdrawal of substitution Hormonotherapy in severe Hypothyroidism

Slim Khaldi*, MD; Pierre Basiaux, MD; Nelly Denute, Bernard Dan, MD, PhD; Charles Kornreich, MD; PhD
Brugmann University Hospital, Department of Psychiatry. Brussels, Belgium. Email: Khaldislim@yahoo.fr,
Tel: +3224772731.

Historically, abnormalities of the thyroid axis have been to be involved in many psychiatric disorders. Since 1874, Gull, followed by Ord in 1878, included psychiatric symptoms such as cognitive dysfunctions, paranoid psychosis and mood changes in their description of myxoedema. Classically, hypothyroidism is associated with depression. To our knowledge, there are very few reports describing the occurrence of mania in patients presenting an overt hypothyroidism state, and none in lithium-naïve patients without mood disorders antecedents.

We report a 53-year-old woman, free of any psychiatric history, who presented a typical manic episode after abruptly stopping thyroid substitution hormonotherapy. She had been taking this treatment since thyroidectomy performed 13 years earlier to treat Hashimoto thyroiditis.

This unusual complication might be due to a sharp fall of circulating thyroid hormones inducing imbalance in cerebral catecholamine resulting in increased dopaminergique tone.

This report stresses the importance of compliance in thyroidectomized patients taking substitution therapy.

Key words: Mania, Hypothyroidism, Bipolar disorder, thyroid-stimulating hormone, Dopamine.

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