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Mental Health (Expert Forum)
Hormone Induced Paranoid Psychosis
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.
Hormone Induced Paranoid Psychosis
by John, Jun 05, 2000 12:00AM
Can anybody shed some light on hormone indiced paranoid psychosis following an operation for total hysterectomy. The after effects have included fears that the husband intended harm to the woman. This followed a very low dosage of oestrogen after the removal of the ovaries, which was further reduced by swimming in a humid climate.
Doctor's Answer
by HFHS MD - RG, Jun 05, 2000 12:00AM
Potentially any drug or medical condition can cause a mental condition. Some drugs especially street drugs cause psychosis more commonly.
There is no exact explanation why some drugs or hormones can cause psychosis and to others not but it is likely that the change in the body's homeostasis could have caused a disruption of the chemicals in the brain. Sometimes, the rapid increase in dosage of the estrogen can also cause this condition
This is treated by lowering the dose of the estrogen or if necessary to discontinue it for a while and restart with a low dose and increase slowly in weeks duration.
There is no exact explanation why some drugs or hormones can cause psychosis and to others not but it is likely that the change in the body's homeostasis could have caused a disruption of the chemicals in the brain. Sometimes, the rapid increase in dosage of the estrogen can also cause this condition
This is treated by lowering the dose of the estrogen or if necessary to discontinue it for a while and restart with a low dose and increase slowly in weeks duration.
A search in medline showed few case reports. You might be be interested in the attached abstract.
Role of estradiol in puerperal psychosis.
Psychopharmacology (Berl) 1999 Nov;147(1):108-10
(ISSN: 0033-3158)
Ahokas A; Aito M Department of Psychiatry, Helsinki City Hospital, Finland. antti.***@****.
RATIONALE: Postpartum period has been considered a time of increased risk for the development of psychiatric disorders with long-lasting adverse consequences. Psychoses are the most severe of these illnesses and can be resistant to psychiatric medication. OBJECTIVE: We present two women with puerperal psychosis who had low serum estradiol, were refractory to neuroleptic medication but responded successfully to estradiol treatment. METHODS: Serum estradiol concentration was measured at baseline and during the treatment with sublingual 17-beta estradiol. Treatment effect was evaluated using Brief Psychiatric Rating Scale. RESULTS: Both patients had a low pretreatment estradiol concentration (28 and 54 pmol/l). During treatment with estradiol, the rise in serum estradiol coincided with a decline of psychotic symptoms. Discontinuation of estradiol treatment resulted in a rebound of florid psychotic symptoms in both cases. CONCLUSIONS: Estradiol may have a causal relation to postpartum psychosis and significance in the treatment of this illness.
A search in medline showed few case reports. You might be be interested in the attached abstract.
Role of estradiol in puerperal psychosis.
Psychopharmacology (Berl) 1999 Nov;147(1):108-10
(ISSN: 0033-3158)
Ahokas A; Aito M Department of Psychiatry, Helsinki City Hospital, Finland. antti.***@****.
RATIONALE: Postpartum period has been considered a time of increased risk for the development of psychiatric disorders with long-lasting adverse consequences. Psychoses are the most severe of these illnesses and can be resistant to psychiatric medication. OBJECTIVE: We present two women with puerperal psychosis who had low serum estradiol, were refractory to neuroleptic medication but responded successfully to estradiol treatment. METHODS: Serum estradiol concentration was measured at baseline and during the treatment with sublingual 17-beta estradiol. Treatment effect was evaluated using Brief Psychiatric Rating Scale. RESULTS: Both patients had a low pretreatment estradiol concentration (28 and 54 pmol/l). During treatment with estradiol, the rise in serum estradiol coincided with a decline of psychotic symptoms. Discontinuation of estradiol treatment resulted in a rebound of florid psychotic symptoms in both cases. CONCLUSIONS: Estradiol may have a causal relation to postpartum psychosis and significance in the treatment of this illness.