Testosterone therapy caused psychosis in an Indian patient with Klinefelter syndrome
- Prolonged testosterone therapy in a patient with Klinefelter syndrome caused psychosis.
- He heard the voices of God and his own organs – vivid auditory hallucinations.
- The case was published in the journal Primary Care Companion for CNS Disorders.
In a recent medical report, Indian scientists described an unusual development of psychopathology in a patient with a genetic disorder – Klinefelter syndrome (47,XXY). The condition is characterized by hypogonadism, low levels of endogenous testosterone, and often requires hormone replacement therapy.
To correct hormonal deficiency, the patient received long-term testosterone injections. According to the treating physicians, the course of therapy lasted several years, which corresponds to standard recommendations for maintaining sex hormones in men with this syndrome.
After some time following the start of treatment, the patient developed psychotic symptoms: he began to hear voices, which he interpreted as the 'voice of God' and 'voices of his own body parts.' These auditory hallucinations were accompanied by anxiety, sleep disturbances, and a decline in social functioning.
A psychiatric examination confirmed the presence of acute psychosis with pronounced auditory hallucinations. The medical team ruled out other possible causes, such as the use of psychoactive substances, neurological diseases, or acute metabolic disorders.
Possible mechanisms
There is data indicating a link between high levels of testosterone and changes in the functioning of the brain's dopaminergic system, which may increase the risk of developing psychotic states in predisposed individuals. At the same time, patients with genetic anomalies, including Klinefelter syndrome, may have a more sensitive mental status to hormonal fluctuations.
The authors of the publication emphasize that this case does not indicate a systemic danger of testosterone therapy, but highlights the need for careful monitoring of the mental state in patients receiving long-term hormonal medications, especially in the presence of predisposing factors.
As part of the treatment, the patient underwent an adjustment of the hormonal regimen and was prescribed antipsychotic therapy, after which the symptoms gradually decreased. Doctors recommend regular psychiatric evaluations as part of a comprehensive approach to the treatment of Klinefelter syndrome.
The case was published in the journal Primary Care Companion for CNS Disorders, where it is considered an example of a rare but significant side effect of hormone replacement therapy. The authors call for further research into the relationship between sex hormones and mental disorders, as well as the development of recommendations for the prevention of such complications.
Source: N+1
