A syndrome of psychosis following discontinuation of an estrogen-progestogen contraceptive and improvement following replacement: A case report.
Mild forms of psychosis associated with low estrogen levels during the perimenopause are relatively frequent. There is scarce data on severe forms of psychosis in these conditions. We report the case of a 51-year-old woman with no previous psychiatric history who amputated her hand in a 'psychotiform' state after discontinuation of her contraceptive medication. Having subsequently jumped out of a window, she suffered a fracture of the dens with central spinal cord injury and symptoms of cruciate paralysis. The patient stabilized under a combined therapy with estrogen-progestogen substitution, antipsychotic medication and add-on oxcarbazepine.
Huber
T J
TJ
Department of Clinical Psychiatry and Psychotherapy, Medical School Hannover, Germany. t.j.huber@gmx.de
Nickel
V
V
Tröger
M
M
Schneider
U
U
Husstedt
H
H
Emrich
H M
HM
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D003277:Contraceptives, Oral, Combined / Q000009:adverse effects; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D007006:Hypogonadism / Q000150:complications* / Q000209:etiology; D011618:Psychotic Disorders / Q000150:complications* / Q000188:drug therapy* / Q000209:etiology; D012652:Self Mutilation / Q000209:etiology*; D013375:Substance Withdrawal Syndrome / Q000150:complications* / Q000188:drug therapy*; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003277:Contraceptives, Oral, Combined