Psychosis following carbimazole-induced acute alteration of hyperthyroid status

Abstract

Abrupt normalization of hyperthyroid state with antithyroid drugs is reported to precipitate psychosis. We report the development of acute psychosis in a 20-year-old woman, following 30 days use of tablet carbimazole 10 mg for hyperthyroidism due to the multinodular goiter. At the time of presentation, she was euthyroid with a resolution of hyperthyroid status both clinically and biochemically. After 20 days treatment with tablet olanzapine 10 mg/day and stoppage of carbimazole, psychotic symptoms remitted completely and she has since remained in a euthyroid state and free from psychotic symptoms. This case highlights the development of psychosis in individuals, following rapid restoration to normal serum thyroid hormone levels in hyperthyroid individuals with carbimazole.

Keywords

• Carbimazole
• euthyroid state
• multinodular goiter
• psychosis