AI Article Synopsis
- Hypothyroidism can cause neuropsychiatric symptoms like cognitive slowing and psychosis, sometimes referred to as "myxedema madness".
- Antipsychotic medications are often prescribed for these symptoms, but they may actually lower free thyroxine levels, worsening hypothyroid symptoms.
- The recommended treatment combines thyroid hormone replacement (like levothyroxine) with antipsychotics (such as risperidone) for managing psychosis in hypothyroid patients.
Article Abstract
Hypothyroidism is one of the common comorbidities seen in patients with psychiatric conditions. Sometimes few patients may present with neuropsychiatric symptoms such as cognitive slowing, depression, or psychosis ("myxedema madness"). These patients are managed with antipsychotic medications while admitting laboratory works are processed. It has been found that antipsychotic use is associated with lower free thyroxine levels, so untreated hypothyroid patients may experience worsening of symptoms with antipsychotic use. It is recommended that hypothyroid patients with psychosis be treated for the underlying hypothyroidism with thyroid hormone replacement. In this article, we are presenting a case of a hypothyroid patient presenting to a psychiatric facility for worsening psychosis and persecutory delusions, and medication non-compliance to levothyroxine. We also discuss the management of psychosis in a patient with worsening hypothyroidism with a combination regimen: levothyroxine and risperidone.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7526983 | PMC |
| http://dx.doi.org/10.7759/cureus.10152 | DOI Listing |
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