Calcium, magnesium, and psychotic symptoms in a girl with idiopathic hypoparathyroidism

A case of psychosis due to idiopathic hypoparathyroidism (IHP) has been followed for over 9 years. The optimal treatment for IHP psychosis was found to be a combination of ergocalciferol and fairly large doses of antipsychotic medication. In general, psychotic episodes occurred when there was hypocalcemia, hypercalcemia, or hypomagnesemia. Antipsychotic medication was not efficacious unless serum calcium and magnesium levels were both normal. It is suggested that psychiatric disturbances in hypoparathyroidism and treatment resistance to antipsychotic medication in other functional psychoses may also be related to hypomagnesemia.