Myxedematous psychosis
| Myxedematous psychosis |
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Myxedema psychosis, more colloquially known as myxedema madness, is a relatively uncommon consequence of hypothyroidism, particularly Hashimoto's thyroiditis. A chronically under-active thyroid can lead to slowly progressive dementia, delirium, and in extreme cases to hallucinations, coma, or psychosis, particularly in the elderly.
Treatment is via the standard treatment for hypothyroidism with thyroxine replacement.
Oral T4, or in especially acute cases liothyronine, a sodium salt of T3. Hormone replacement in these patients usually reverses the psychotic symptoms, but may not help with cognitive deficits caused by changes in metabolic activity in the CNS.
The "myxedema" part of the name simply refers to the pitting edema common to hypothyroidism.
References
Hypothyroidism Presenting as Psychosis: Myxedema Madness Revisited. Heinrich TW, Grahm G. Prim Care Companion J Clin Psychiatry. 2003; 5(6): 260-266. [3]
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