Mania in association with hydrocortisone replacement for Addison's disease.
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.
Ur
E
E
Department of Endocrinology, St Bartholomew's Hospital, London, UK.
Turner
T H
TH
Goodwin
T J
TJ
Grossman
A
A
Besser
G M
GM
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
D006854:Hydrocortisone