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Paranoid delusions and auditory hallucinations associated with digoxin intoxication
The Journal of Nervous and Mental Disease
|November 1, 1978
Summary
An 83-year-old woman experienced psychiatric symptoms like delusions and hallucinations due to toxic digoxin levels. Her mental state improved as digoxin levels returned to normal, highlighting a potential drug-induced psychosis.
Area of Science:
- Geriatric Psychiatry
- Clinical Toxicology
- Pharmacology
Background:
- Digoxin is a cardiac glycoside used to treat heart failure and arrhythmias.
- Elevated digoxin levels can lead to toxicity, manifesting with various systemic symptoms.
- Psychiatric manifestations of digoxin toxicity are less common but have been reported.
Observation:
- An 83-year-old female presented with new-onset paranoid delusions and auditory hallucinations.
- The patient remained alert, oriented, and hemodynamically stable.
- No other medical conditions were identified to explain the psychiatric symptoms.
Findings:
- Serum digoxin levels were found to be toxic.
- Cardiovascular and metabolic evaluations were unremarkable.
- Psychiatric symptoms resolved completely with the normalization of serum digoxin levels.
Implications:
- This case underscores the importance of considering digoxin toxicity in elderly patients with new-onset psychiatric symptoms.
- Monitoring serum digoxin levels is crucial for patients exhibiting unusual neurological or psychiatric changes.
- Early recognition and management of digoxin toxicity can prevent prolonged morbidity and ensure rapid recovery.