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ARTICLE |

Lithium Prophylaxis of Corticotropin-lnduced Psychosis FREE

William E. Falk, MD; Mark W. Mahnke, MD; David C. Poskanzer, MD
[+] Author Affiliations

Reprint requests to Department of Neurology, Massachusetts General Hospital, Boston, MA 02114 (Dr Poskanzer).


JAMA. 1979;241(10):1011-1012. doi:10.1001/jama.1979.03290360027021
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Corticotropin is one of the few accepted treatments for acute exacerbations of multiple sclerosis and retrobulbar neuritis. Psychosis is a serious side effect usually necessitating discontinuation of the drug therapy. Because mood disorders preponderated in most patients previously described with this psychosis, 27 patients were empirically treated with lithium carbonate concurrently with corticotropin. In none of the patients treated with lithium did a psychotic reaction occur, although in a comparable group of 44 patients previously treated identically with corticotropin but without lithium, six (14%) became psychotic.

(JAMA 241:1011-1012, 1979)

REFERENCES

Cass LJ, Alexander L, Enders M:  Complications of corticotropin therapy in multiple sclerosis . JAMA 197:173-178, 1966;.
Glazer GJ:  Psychotic reactions induced by corticotropin (ACTH) and cortisone . Psychosom Med 15:280-291, 1953;.
Clark LD, Quarton GC, Cobb S, et al:  Further observations on mental disturbances associated with cortisone and ACTH therapy . N Engl J Med 249:178-183, 1953;.
Smith CR, Barish J:  Psychiatric disturbance in endocrinologic disease . Psychosom Med 34:69-86, 1972;.
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: I. Limbic system-adrenocortical dysfunction . Arch Gen Psychiatry 33:1039-1044, 1976;.
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: II. Discrimination of depressed from nondepressed patients . Arch Gen Psychiatry 33:1051-1057, 1976;.
Carroll BJ:  Psychiatric disorders and steroids , in Usdin E, Hamburg DA, Barchas JD (eds): Neuroregulators and Psychiatric Disorders . New York, Oxford University Press Inc, 1977;, pp 276-283.
Quarton GC, Clark LD, Cobb S, et al:  Mental disturbances associated with ACTH and cortisone: A review of explanatory hypothesis . Medicine 34:13-50, 1955;.
Kemp K, Lion JR, Magram G:  Lithium in the treatment of a manic patient with multiple sclerosis . Dis Nerv Syst 38:210-211, 1977;.
Blazer DG, Petrie WM, Wilson WP:  Affective psychoses following renal transplant . Dis Nerv Syst 37:663-667, 1976;.

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Cass LJ, Alexander L, Enders M:  Complications of corticotropin therapy in multiple sclerosis . JAMA 197:173-178, 1966;.
Glazer GJ:  Psychotic reactions induced by corticotropin (ACTH) and cortisone . Psychosom Med 15:280-291, 1953;.
Clark LD, Quarton GC, Cobb S, et al:  Further observations on mental disturbances associated with cortisone and ACTH therapy . N Engl J Med 249:178-183, 1953;.
Smith CR, Barish J:  Psychiatric disturbance in endocrinologic disease . Psychosom Med 34:69-86, 1972;.
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: I. Limbic system-adrenocortical dysfunction . Arch Gen Psychiatry 33:1039-1044, 1976;.
Carroll BJ, Curtis GC, Mendels J:  Neuroendocrine regulation in depression: II. Discrimination of depressed from nondepressed patients . Arch Gen Psychiatry 33:1051-1057, 1976;.
Carroll BJ:  Psychiatric disorders and steroids , in Usdin E, Hamburg DA, Barchas JD (eds): Neuroregulators and Psychiatric Disorders . New York, Oxford University Press Inc, 1977;, pp 276-283.
Quarton GC, Clark LD, Cobb S, et al:  Mental disturbances associated with ACTH and cortisone: A review of explanatory hypothesis . Medicine 34:13-50, 1955;.
Kemp K, Lion JR, Magram G:  Lithium in the treatment of a manic patient with multiple sclerosis . Dis Nerv Syst 38:210-211, 1977;.
Blazer DG, Petrie WM, Wilson WP:  Affective psychoses following renal transplant . Dis Nerv Syst 37:663-667, 1976;.
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