Akademik Veri Yönetim Sistemi
Uluslararası Psikofarmakoloji Kongresi, Antalya, Türkiye, 18 - 21 Nisan 2019, cilt.29, ss.134
ABSTRACT
Anabolic steroids are common in athletes interested in bodybuilding and weight lifting. These people use HcG to reduce endocrinological side effects such as testicular atrophy within cycles of steroid use. We present a psychotic case with catatonic features in a patient using hcG after anabolic steroid use.
Case presentation: 17-year-old high school student, single male patient was brought to our
outpatient clinic by his family for the last 20 days with complaints of introversion, denial of
eating, denial of speech, slowing of movements, and insignificant behaviors. His history
included insomnia, crying attacks, and guilt statements. It was learned that oral anabolic
steroid abuse started about 4 months ago and continued for 2 months. In the last 3 weeks
before his illness, his family reported that he had a previous IM hcG 5000 IU abuse weekly. It
has been learned that the patient has been dealing with bodybuilding for 2 years and
sometimes steroid abuse has been observed in the past and his brother has been followed
up with bipolar disorder. In the mental examination, he was conscious, and his orientation
was complete, his mutism was present. He had advanced psychomotor retardation and
blocks of thought. Apathic facial expression was seen. The patient was hospitalized in our
clinic and routine blood tests, cranial MRI, EEG and urine screening were performed. There
were no pathological findings except neutrophilia. In the foreground, the patient was given
lorazepam 1 mg orally with catatonia diagnosis. Because of the benefit of the patient with
increasing speech, the lorazepam dose was increased to 1 mg three times a day. In the
follow-up, olanzapine 5 mg once a day was added to the treatment for referential delusions
and the dosing increased up to 15 mg/day. Haloperidol 1 mg once a day was added for
residual psychotic symptoms of the patient when described sedation. The patient was
discharged with partial remission with lorazepam 3 mg/day, olanzapine 15 mg/day and
haloperidol 1 mg/day treatment. Although the patient had intermittent steroid use in the
past, the recent emergence of psychotic and catatonic symptoms suggested that hcG may
be effective in the forefront. Nevertheless, the effect of steroid use and familial burden could
not be excluded. In the literature, a case of first-episode mania which developed after the
use of hcG without prescription for weight loss was reported. HcG needs to be addressed in
terms of triggering psychotic symptoms, in this topic advanced evidence is needed.