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Graves' hyperthyroidism-induced psychosis treated with aripiprazole--a case report
Livia R Macedo1, Jehan Marino, Brady Bradshaw
1Department of Pharmacy Services, University of Mississippi Medical Center, MS, USA.
Journal of Pharmacy Practice
|July 31, 2012
Summary
This case study highlights the successful use of aripiprazole in managing psychosis induced by Graves
Area of Science:
- Endocrinology
- Psychiatry
- Pharmacology
Background:
- Graves' disease, an autoimmune disorder, can manifest with psychiatric symptoms including psychosis.
- Limited evidence exists regarding the efficacy of atypical antipsychotics for Graves' hyperthyroidism-induced psychosis.
Observation:
- A 47-year-old female with bipolar disorder history presented with acute agitation, psychosis, and delusions.
- Diagnostic workup revealed Graves' disease with suppressed thyroid-stimulating hormone and elevated thyroid hormones.
- The patient also exhibited atrial fibrillation and tachycardia.
Findings:
- Aripiprazole was initiated at 10 mg daily, titrated to 15 mg, leading to significant improvement in psychotic symptoms within 16 days.
- Concomitant treatment included methimazole for hyperthyroidism and metoprolol for tachycardia.
- This case represents the first reported instance of aripiprazole effectively treating psychosis associated with Graves' hyperthyroidism.
Implications:
- Aripiprazole shows promise as a treatment option for psychosis in patients with Graves' disease.
- Further research is warranted to establish optimal dosing, duration, and long-term efficacy of aripiprazole in this population.
- This case underscores the importance of considering endocrine disorders in psychiatric presentations.
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