Sertraline alleviated osmophobia caused by partial hypopituitarism with isolated ACTH deficiency.
OBJECTIVE
Hyperosmia may be an early manifestation of hypocortisolism and may be mistakenly diagnosed as osmophobia. However, sertraline therapy incidentally alleviated the phobic symptoms and hindered accurate diagnosis.


METHODS
A 41-year-old man was diagnosed as having osmophobia. Initial sertraline treatment relieved the symptoms, but its cessation resulted in recurrence of osmophobia. Endocrinological examinations revealed severe hypocortisolism and partial hypopituitarism with isolated adrenocorticotropic hormone deficiency. After prednisolone supplementation, his condition dramatically improved.


CONCLUSIONS
We recommend that, before intervention with selective serotonin reuptake inhibitors is performed, the hypothalamic-pituitary-adrenal axis be evaluated in psychiatric patients presenting with co-occurring olfactory change.
Taipei City Psychiatric Centre, Taipei City Hospital, Taiwan.
Yu-Heng
YH
Kuo
Yun
Y
Chang
Hsi-Chung
HC
Chen
Shih-Cheng
SC
Liao
D000324:Adrenocorticotropic Hormone / Q000172:deficiency*; D000328:Adult; D004700:Endocrine System Diseases / Q000150:complications / Q000188:drug therapy*; D030342:Genetic Diseases, Inborn / Q000150:complications / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000188:drug therapy*; D007018:Hypopituitarism / Q000150:complications / Q000188:drug therapy*; D008297:Male; D009812:Odorants; D010698:Phobic Disorders / Q000188:drug therapy*; D011239:Prednisolone / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*
D000324:Adrenocorticotropic Hormone; D005938:Glucocorticoids; D011239:Prednisolone; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline