A hypothyroid patient may have a number of psychiatric problems which may become worse after being started on thyroxine therapy.
Psychiatric problems that may occur in a patient with hypothyroidism:
(1) mania
(2) hypomania
(3) psychosis ("myxedema madness")
(4) delirium
(5) paranoia
To avoid worsening of symptoms during thyroxine therapy, consider:
(1) starting thyroxine at a lower dose
(2) increasing the dose slowly
(3) treating comorbid conditions such as nutritional deficiencies
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Specialty: Psychiatry, Endocrinology
