Gonadotropin-releasing hormones and Psychosis

Background: There have been reports of transient psychosis in women medicated for gynecologic conditions.Objective: The aim of this paper was to explore this literature.Method: The PubMed and Google Scholar databases were searched for relevant case reports Results: The following reports were found: psychosis induced by gonadotropinreleasing hormone in the treatment of endometriosis, by clomiphene treatment for infertility, by bromocriptine treatment for milk suppression and by the withdrawal of domperidone prescribed as a galactologue as well as by the withdrawal of estrogen replacement therapy.Conclusion: In susceptible women, psychotic symptoms can result from treatments that reduce estrogen levels, such as leuprolide acetate or clomiphene, or treatments that increase dopamine levels (bromocriptine). Psychosis can also be caused indirectly when estrogen treatment is discontinued or dopamine antagonism (e.g. domperidone) withdrawn. Estrogen-reducing and dopamine-increasing treatments used in gynecology need to be carefully monitored. Publication Type: Journal: Article Source: EMBASE Title: Psychosis after FSH and LH stimulation for ovocytes preservation in gender dysphoriaa case report Citation: European Psychiatry, March 2015, vol./is. 30/(929), 0924-9338 (31 Mar 2015) Author(s): Oliveira C., Alves S., Oliveira S., Agostinho C., Avelino M. Language: English Abstract: Introduction: Gender dysphoria is a new diagnostic class in DSM-5 that reflects a new conceptualization of the disorder emphasizing the phenomenon of 'gender incongruence'. It refers to the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender. Hormone and/or surgery are treatment options available. There is some clinical evidence that patients under gonadotropin-releasing hormone (GnRH) agonists may develop symptoms consistent with various psychiatric disorders with and without psychotic features. Objectives and Aims: To review new DSM-5 conceptualization of gender dysphoria and psychiatric side effects of ovocyte stimulation drugs. Also to report one selected clinical case of psychosis after FSH and LH stimulation in a patient under female to male sex reassignment process. Methods: The authors have conducted an online search on PubMed on psychosis after ovocytes stimulation and gender dysphoria and systematically reviewed a case report. Results: There is little evidence of psychiatric side-effects of GnRH agonist. Case report: 22 years old male with diagnosis of gender dysphoria under female to male sex reassignment process with FSH and LH stimulation to ovocyte preservation that acutely developed psychiatry symptoms of bizarre behaviour, irritability, flight of ideas, soliloquies and erotomaniac delusions that remit on antipsychotic drugs. Conclusions: Gender dysphoria is a new diagnostic class in DSM-5. There are multiple hormone and/or surgery treatments options. There is little evidence hormone treatments are associated with psychiatric side-effects, namely psychosis. To conduct a well-designed clinical trial on psychiatric symptoms related with hormone treatment in gender dysphoria patients is needed. Publication Type: Journal: Conference Abstract