Rapid Reversal of Myxedema Madness with Triiodothyronine
Authors: DAVID MICHAEL COOK
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 June 1986Rapid Reversal of Myxedema Madness with TriiodothyronineDAVID MICHAEL COOK, M.D., PATRICK J. BOYLE, M.D.DAVID MICHAEL COOK, M.D.Search for more papers by this author, PATRICK J. BOYLE, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-104-6-893_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo 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...References1. LIBOWDURELL LJ. Clinical studies on the relationship between psychosis and the regulation of thyroid gland activity. Psychosom Med. 1965;28:377-82. CrossrefGoogle Scholar2. EASSON W. Myxedema psychosis-insanity defense in homicide. J Clin Psychiatry. 1980;41:316-8. MedlineGoogle Scholar3. ENGLERBURGER DA. The deiodination of the iodothyronines and of their derivatives in man. Endocr. Rev. 1984;5:151-84. CrossrefMedlineGoogle Scholar4. RIDGWAYMCCAMMONBENOTTIMALOOF EJJF. Acute metabolic responses in myxedema to large doses of intravenous L-thyroxine. Ann Intern Med. 1972;77:549-55. LinkGoogle Scholar5. CHERNOWBURMANJOHNSON BKD. T3 may be a better agent than T4 in the critically ill hypothyroid patient: evaluation of transport across the blood-brain barrier in a primate model. Crit Care Med. 1983;11:99-104. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Oregon Health Sciences University Portland, OR 97201 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByMyxedema Psychosis: Neuropsychiatric Manifestations and Rhabdomyolysis Unmasking HypothyroidismSevere Hypothyroidism Manifested as Acute Mania With Psychotic Features: A Case Report and Review of the LiteratureResolution of Hypothyroidism After Correction of Somatovisceral Reflex Dysfunction by Refusion of the Cervical SpineThyroid disease and the nervous systemThyroid Disease and the Nervous SystemThyroid and AgingMyxedema psychosis with grade II hypothyroidismHypothyroidism and Cognition: Preliminary Evidence for a Specific Defect in MemorySelective Transport Across the Blood-Brain BarrierWILLIAM A. BANKS, M.D., ABBA J. KASTIN, M.D., EDWARD A. MICHALS 1 June 1986Volume 104, Issue 6Page: 893-894KeywordsAttentionHypothyroidismThyroxineTriiodothyronine Issue Published: 1 June 1986 PDF DownloadLoading ...