Developmentally disabled, over weight, paranoia, agitation, short term memory loss. On antipsychotics. Help?
Patient: 29 yo developmentally disabled adopted daughter, (Hx. precocious puberty age 6, MRI negative, depolupron age 7 - 12), overweight but no other medical problems . Had sudden onset of psychosis (paranoid, aggitated and short term memory loss) lasting 7 days - 4 days were pretty bad, 3 days with improvement each day.  Started her mensural period two days after onset of psychotic episode.  ED gave her antipsychiotics and Ativan.... only gave her meds for 3 days and she is on nothing now and back to normal mental state. No other paranoia or episodes of pychosis previously.  Took her for medical check up - labs pending.  MRI of brain w/o and w/ contrast shows empty sella - otherwise negative.    Birth mother paranoid schizophrenic - so somewhat worried about that  possibility - but would seem like late onset?    Now the Q:  Can hormonal imbalances cause such a drastic event (very sudden onset of psychosis)?  Given that it started a few days before her period and the MRI shows empty sella, does this possible match up for a hormonal imbalance to trigger psychosis? Doctor: Hi, Thanks for using health care magic. I have gone through your summary of history.  Psychological disturbances are usually present during peri menstrual period. it may range of irritation to psychosis.  so the answer to your question is yes that hormonal imbalance can cause these type of symptoms.  but you should consult psychiatrist for detailed evaluation and treatment.