Reactions 739 - 20 Feb 1999

★Prasterone

First report of hypomania in an elderly patient: casereport

A 68-year-old man developed symptoms of hypomania afterhe took prasterone [dihydroepiandrosterone] for 6 months toincrease his energy and act as a ‘tonic’. He had a history ofalcohol abuse; however, at the time of presentation, he wasdrinking only 2 beers per day.

The patient presented with rapid, loud and pressuredspeech. He had grandiose thoughts, delusional thinking anddecreased sleep and appetite. He had initially been takingprasterone 100 mg/day, but he had increased the dosage to200–300 mg/day.

The patient was admitted to hospital and showed no signs ofalcohol withdrawal over the next 7 days. He was treated withvalproic acid and after a few days, his thought processesimproved, his speech became less pressured and his sleepimproved. He was diagnosed with substance-induced mooddisorder.

Author comment: ‘Clinicians are urged to specificallyquestion patients about OTC [over-the counter] supplements,vitamins, and herbal remedies as part of an initial drug historyand consider their potential role in adverse psychiatricreaction.’Markowitz JS, et al. Possible dihydroepiandrosterone-induced mania. BiologicalPsychiatry 45: 241-242, 15 Jan 1999 - USA 800739970

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of hypomania associatedwith prasterone.

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Reactions 20 Feb 1999 No. 7390114-9954/10/0739-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved