DAVID MICHAEL COOK, M.D.; PATRICK J. BOYLE, M.D.
To the editor: Two men, aged 25 and 42, developed severe psychosis while hypothyroid. Both presented with marked thought disorder: one was combative; the other, hallucinatory. Hypothyroidism was chronic and severe in one and mild in the other; thyrotrophin concentrations were 97 and 29 μU/mL in the two patients, respectively. Treatment with oral triiodothyronine reversed the psychosis in each, in 48 and 36 hours, respectively. Previous reports have suggested a much slower response rate with thyroxine alone (1, 2).
Myxedema associated with psychosis is a dramatic and rare clinical event. Few case studies have been reported, and no comparative clinical
COOK DM, BOYLE PJ. Rapid Reversal of Myxedema Madness with Triiodothyronine. Ann Intern Med. ;104:893–894. doi: 10.7326/0003-4819-104-6-893_2
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Published: Ann Intern Med. 1986;104(6):893-894.
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