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Mania in a case of hyperparathyroidism.

Brown SW, Vyas BV, Spiegel DR

Eastern Virginia Medical School, Dept. of Psychiatry and Behavioral Sciences, 825 Fairfax Ave., Norfolk, VA 23507, USA. spiegedr@evms.edu

Psychiatric manifestations of primary hyperparathyroidism are mediated by hypercalcemia. To date, most evidence indicates that hypercalcemia and increased cerebrospinal-fluid calcium levels produce depression symptoms. Presented here is a case report of a 52-year-old woman in a manic state. She had no psychiatric history but had substantially elevated parathyroid hormone levels and hypercalcemia. On the basis of emerging evidence that calcium channel-blockers effectively treat mania, the authors propose that elevated calcium levels may act through multiple mechanisms or on various regions of the brain to produce a spectrum of psychiatric symptoms that should now include mania as a possibility.

Published 4 May 2007 in Psychosomatics, 48(3): 265-8.
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