surgery, and complete remission of symptoms on escitalopram. Our discussion of the case is placed in the context of the recent literature review on the topic of.
Responsiveness of depression to parathyroidectomy in a patient with primary hyperparathyroidism: a case report. Co-authors khalid shehatto, M.D., Ahmed Elaghoury, M.D. The incidence of primary hyperparathyroidism (PHPT) is about 21 cases per 100,000 person-years and is usually caused by a solitary parathyroid adenoma. Patients suffering from hyperparathyroidism may display a range of neuropsychiatric symptoms, including depression, anxiety, behavioral disturbances and psychosis, and reduced neurocognitive function. The diagnosis of pHPT may easily be missed if not suspected by the clinician and if the appropriate biochemical tests are not performed. The pathogenesis of psychiatric symptoms in PHPT remains unclear. Several studies suggest that surgical removal of the parathyroid adenomas may result in a clinical improvement of psychiatric symptoms. We present a patient with pHPT and treatment-resistant depression, where the level of calcium was in the normal range. His symptoms decreased in severity after surgery, and complete remission of symptoms on escitalopram. Our discussion of the case is placed in the context of the recent literature review on the topic of pHPT and neuropsychiatric symptoms. Mr. A, a 35-year-old man with long and recurring periods of depressive symptoms since the age of 12. He had recurring suicidal thoughts and one suicidal attempt using organophosphorus insecticide ten years ago.Most of the antidepressants were tried including drug combinations beside ECT with partial response. He was on escitalopram 20mg od and duloxetine 60mg od. On early 2017, He developed acute anginal pain after which he was admitted for investigations, then he was diagnosed as pHPT and met criteria for parathyroidectomy.He was operated on February 2017. His depressive symptoms severity decreased with time. Currently, he is using escitalopram 10mg tab od with complete remission. CONCLUSIONS: Depression and anxiety appear to be related to pHPT. parathyroidectomy seems to reduce psychopathologic symptoms
