title: Mania in association with hydrocortisone replacement for Addison's disease.
abstract: A 32 year old woman with untreated primary adenocortical insufficiency presented with prominent depressive symptoms. Upon treatment with physiological doses of glucocorticoids she developed a self-limiting acute manic illness. We suggest that up-regulation of hippocampal glucocorticoid receptors as a consequence of prolonged hypocortisolaemia resulted in increased cerebral sensitivity to exogenous corticosteroids, which are known to precipitate manic symptoms in some normal individuals when given in supraphysiological doses.
authors.affiliation: Department of Endocrinology, St Bartholomew's Hospital, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Ur
authors.forename: T H
authors.initials: TH
authors.lastname: Turner
authors.forename: T J
authors.initials: TJ
authors.lastname: Goodwin
authors.forename: A
authors.initials: A
authors.lastname: Grossman
authors.forename: G M
authors.initials: GM
authors.lastname: Besser
mesh_terms: D000208:Acute Disease; D000224:Addison Disease / Q000188:drug therapy*; D000328:Adult; D001714:Bipolar Disorder / Q000139:chemically induced*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D006854:Hydrocortisone