Article Text


Mania in association with hydrocortisone replacement for Addison's disease.
  1. E. Ur,
  2. T. H. Turner,
  3. T. J. Goodwin,
  4. A. Grossman,
  5. G. M. Besser
  1. Department of Endocrinology, St Bartholomew's Hospital, London, UK.


    A 32 year old woman with untreated primary adenocortical insufficiency presented with prominent depressive symptoms. Upon treatment with physiological doses of glucocorticoids she developed a self-limiting acute manic illness. We suggest that up-regulation of hippocampal glucocorticoid receptors as a consequence of prolonged hypocortisolaemia resulted in increased cerebral sensitivity to exogenous corticosteroids, which are known to precipitate manic symptoms in some normal individuals when given in supraphysiological doses.

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