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Case Report
Lithium and endocrine dysregulation in decompensated bipolar disorder with psychotic features
1 Resident Physician, Department of Psychiatry, John Peter Smith Hospital, Fort Worth, Texas, United States
2 Osteopathic medical student, University of North Texas College of Osteopathic Medicine, Fort Worth, Texas, United States
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Noah Begley
John Peter Smith Hospital, 1500 S Main St., Fort Worth, TX 76104,
United States
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Article ID: 100135Z06NB2025
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Begley N, Tariq Z, Yip M, Sadaf S, Rajan M. Lithium and endocrine dysregulation in decompensated bipolar disorder with psychotic features. Case Rep Int 2025;14(2):12–15.ABSTRACT
Introduction: Bipolar disorder (BD) is a mood disorder characterized by manic episodes, depressive episodes, mixed states, and psychotic symptoms. It affects over 2% of the global population and is associated with higher suicide rates than the general population. Treatment options include antipsychotics, anticonvulsants, and lithium, which are effective for long-term management and suicide prevention. Lithium has long been the gold standard for BD treatment; however, it can cause thyroid and parathyroid dysfunction. Patients receiving medications for medical comorbidities can be at higher risk for side effects.
Case Report: In this case, a 66-year-old female with bipolar I disorder and multiple endocrine abnormalities was admitted during a manic episode with psychotic features that followed their discontinuation of lithium.
Conclusion: This case illustrates the complexities of managing BD with concurrent endocrine disorders and the importance of collaboration between specialty providers to maintain patient medical and psychiatric safety.
Keywords: Bipolar disorder, Endocrinology, Pharmacology, Psychiatry
SUPPORTING INFORMATION
Acknowledgments
The authors would like to thank our attending physician Michelle Oyeka, MD for her teaching, mentorship, and encouragement throughout the writing and publication of this report.
Grammarly Inc. generative AI was used in both the introduction and conclusion to correct grammatical errors and summarize information.
Noah Begley - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Zuha Tariq - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Maggie Yip - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Saad Sadaf - Interpretation of data, Drafting the article, Final approval of the version to be published
Mia Rajan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Noah Begley et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
