I am a new member here. My brother, 24 years of age, has Addison's disease (for 16 years), as well as he has been diagnosed with hypothyroidism (1.5 years).

In the last month he has developed psychosis or lost touch with reality.

What that means is that he has been hearing voices, auditory hallucinations, he is easily confused, depressed, unmotivated, and as of late delusional.

We have had to admit him in a psychiatric hospital here in Toronto Canada where we live.

I was curious to see if any other Addisonians have had similar problems or
heard of anything similar.

My brothers medicines included:

Predisone (5mg)
Dexamethasone (0.25mg)
Florinef (0.1mg)
Synthroid (0.01 micrograms)

But he was taking his medicine incorrectly. He wasn't dividing his doses of
Predisone or Dexamethasone (was suppose to take one in the morning and one in the evening, but he was taking both in the morning). And he was taking two Dexamethasones (so 0.5mg), plus Prednisone (5mg).

Also, he stopped taking his medicine for a period of close to a year. Than he started taking it last month incorrectly and developed this psychosis.

The doctors are checking his THS, T4, T3, ACTH levels now. But I was wondering if anyone heard of this. Psychosis or mental changes from these medications.

We are very worried about my brother.

Any help you can provide will help.

Thanks for the reply and advice Chris.

We were told that my brother was put on both dex and pred because his body was using up the pred too quickly. He would take the 5mg in the morning and his ACTH levels would still be high (around 700). So they put him on the dex in the evening. But he has not been taking any of his medications for about a year. I've talked to other endocrinologists and they too seemed a little surprised that he was on both pred and dex. I wonder if because of he hasn't been taking his meds properly, that could have affected his ACTH levels and the endocrinologist incorrectly put him on the dex to compensate.

You are correct about the synthroid, I mad an error he is taking 0.05mg (or 50 micrograms). But like the other meds, he wasn't taking them for about a year and restarted last month when he started feeling lousy, around the same time the psychosis began.

When he was in emergency they checked his TSH level and it was 3.21. They did not check his T4 or T3 levels.

We recently moved so we have to find him a new endocrinologist which has also been a challenge.

Any advice you or other members could provide would be greatly appreciated.

Chris,

Thank you for "being there"! I referred "achtung" to this board specifically because I thought YOU could help them. I remembered your experiences, and thought you could relate. I knew you would be there for them. That's marvelous! It's fabulous to have this board as a resource.
Take care. :wave: ~ Tracy

But I was wondering if anyone heard of this. Psychosis or mental changes from these medications.


Yes! It's called steroid-induced psychosis. If he is over- or undermedicated it is likely that the psychosis can be caused by the steroids. Due to differences in the human body it is even possible that he develops a steroid psychosis on a physiological dose.
Read this: http://www.drrichardhall.com/steroid.htm

My brother finally seen an endocrinologist. His thyroid tests were as follows:

TSH: 2.77
FT3: 4.5 (3.5 – 6.5)
FT4: 21 (11-23)

He was also found to be deficient in Calcium and Vitamin D.

They only tested his thyroid, and did no tests for his Addisons. When I asked the endocrinologist why his ACTH was not tested, he said that my brother did not present with any symptoms of Addisonian crisis (i.e. nausea, headaches, etc), so there was no need.

My brother is on the following medications:

Predisone (5mg)
Dexamethasone (0.25mg)
Florinef (0.1mg)
Synthroid (0.05mg)

But from January 2004 to May 2004 was taking his medications incorrectly – taking 0.50 dexamethasone (because the pharmacist did not cut his pills in half). In June he developed psychosis and has been hospitalized in a psychiatric ward since, where he is being administered anti-psychotics.

Are his thyroid tests in the normal range?
Is it possible to determine if a person is on the right levels of Addison meds without testing their blood or urine? What is the best test? I mentioned a day curve analysis to the endocrinologist but he had never heard of it and said it wasn’t procedure in his hospital.
Is it common to have a lack of Vitamin D and Calcium for Addisonians? Is there a possibility that my brothers parathyroid gland is not functioning properly?

I don’t have a problem accepting that my brother may have a mental illness, but not before ruling out the impacts of the medications he was on. Any help/insight would be appreciated. Thank you!

Hi! I was Addisonian for 15 years (since the age of 18), took Miticorten (which is Prednisone), later on Hydrocortisone, Florinef and when in crisis Solucortef. I know what you're bother is going through. I was never that low, but I did have a deep depression when I was 19 and nearly lost my hold on life. Fortunately, I'm a Christian and had a big support there, as well as a loving family (which I'm sure your brother has). What I can tell you as someone who has been through the treatment is that cortisone tends to cause mental disturbances and also depression. For years, nobody told me I needed to take vitamin and mineral supplements to stay sane! (except potassium not to dehydrate) and I have found that B complex vitamins as well as Calcium and magnesium (which help me sleep,—Addisonians are very often terrible insomniacs—are crucial, but a very balanced formula will be excellent.) It is not only something mental, it's really biochemical, I had to become terminal to turn things around. I was assisted with enough information by the person treating me to send me rolling. I also had problems with my thryroid (also am pre-diabetic and have had pancreatitis twice. Addison's messes up other glands, it's the nature of the disease itself. But if you take care of yourself, you can survive it.) Look at your brother's diet. See what's missing. Read up on the nutrients that help the brain and mental functions (cortisone really sucks those up!) I can only tell you that I tried it the other way and this one is much better. I am a serene person now, work and have a life! Do some research. Sadly, most endocrinologists don't know these things (I had one from Cornell University!) They are not experts on nutrition. The patient or his family must dig out these things. It's good that you are searching.
I wish you the best.