Anxiety and depression related to elevated dopamine in a patient with multiple mediastinal paragangliomas

Paragangliomas are rare neuroendocrine tumors. Occasionally they secrete catecholamines in sufficient quantities to cause symptoms. These may include psychiatric symptoms such as anxiety and depression. We describe a patient with multiple mediastinal paragangliomas and persistently elevated dopamine levels who presented with anxiety and depression. She later went on to develop paranoid schizophrenia, which we feel was coincidental. This case illustrates anxiety and depressive symptoms associated with elevated dopamine and the importance of awareness of psychiatric manifestations of neuroendocrine tumors among psychiatrists and physicians.