Hyperaldosteronism and bipolar mixed episode: A case report
International Journal of Applied Behavioral Sciences,
Vol. 2 No. 2 (2015),
20 Dey 2016
,
Page 41-43
https://doi.org/10.22037/ijabs.v2i2.8085
Abstract
Introduction: Aldosterone is a steroid hormone produced by the outer section of the adrenal cortex. Both glucocorticoids and mineralocorticoids receptors are present in brain structures (e.g. hippocampus and amygdala) that are involved in behavior such as fear and anxiety. Methods: We report a 54 year old male who was referred from the endocrine ward presented with a dysphoric mood, irritability, insomnia, decreased in appetite, talkativeness, anhedonia, hopelessness, worthlessness, recurrent thought of death, somatic symptoms, which include palpitation and sweating. Mental status examination revealed bipolar 1 disorder, single episode mixed, severe, without psychotic feature based on diagnostic statistical manual of mental disorder (DSM4TR) The aldosterone was high and renin was low. Other clinical examination was normal. Conclusion: The age of onset, no history of mood episodes, atypical feature of this episode and associated hyperaldosteronism suggest the causal role of aldosterone in this episode. The patient was treated with Depakin 500m/d, Quetiapine 50mg/d and Haloperidol 5mg/d. His mental and somatic symptoms improved in 4 weeks. This case can show the relationship between hyperaldosteronism and mood episodes. For future studies, it is decent to do more investigation to find the role of aldosterone in mood regulation. Declaration of Interest: None- Hyperaldosteronism
- Bipolar mood disorder
- mixed episode
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References
Marieb, Elaine N., Essentials of Human Anatomy & Physiology. 9th Edition. San Francisco, CA Pearson Education, 2009. chapter:16, page:629, question number:14
Conn JW, Louis LH (1955). "Primary aldosteronism: a new clinical entity".Transactions of the Association of American Physicians 68: 215–31;
Selye H. Stress and disease. Science. (1955);122 (3171):625–631.
Barnett MW, Larkman PM (June 2007). "The action potential". Practical Neurology 7 (3): 192–7.
Korte SM. Corticosteroids in relation to fear, anxiety and psychopathology. Neuroscience and biobehavioral reviews. (2001);25 (2):117–142.
Künzel h. Anxiety and depressive symptoms in patients with primary aldosteronism in a longitudinal study. Endocrine Abstracts (2012) 29 P74
Sonino N, Fallo F, et al. Psychological aspects of primary aldosteronism. Psychotherapy and psychosomatics. (2006);75 (5):327
Halvacova et al. International Journal of Neuropsychopharmacology (2012), 46 (11), 1394-1397
Apostolopoulou k.gender differences in anxiety and depressive symptoms in patients with primary hyperaldosteronism:a cross sectional study. The world journal of biological psychiatry(2014) Jan;15(1):26-35.
Hlavacova N, Jezova D. Chronic treatment with the mineralocorticoid hormone aldosterone results in increased anxiety-like behavior. Hormones and behavior. 2008;54 (1):90–97
Hendler N. Lithium-responsive hyperaldosteronism in manic patients. Journal of Nervous and Mental Disease . (1975) Jul;161(1):49-54.
Hallberg L. Decreased aldosterone in the plasma of suicide attempters with major depressive disorder. Psychiatry Research . (2011) May 15;187(1-2):135-9.
Murck H, Held K, et al. The rennin–angiotensin–aldosterone system in patients with depression compared to controls—a sleep endocrine study. Biomedical center of Psychiatry. 2003;3:15.
Walton KG, Pugh ND, et al. Stress reduction and preventing hypertension: preliminary support for a psychoneuroendocrine mechanism. The Journal of Alternative and Complementary Medicine1995;1 (3):263–283.
Grippo AJ. Sadness and broken hearts: neurohumoral echanisms and co-morbidity of ischemic heart disease and psychological depression.Journal of Physiology and Pharmacology. 2006;57 (Suppl 11):5–29.
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