leuprolide and Psychotic-Disorders

Topics: Aged; Antineoplastic Agents, Hormonal; Humans; Leuprolide; Male; Prostatic Neoplasms; Psychotic Disorders; Schizophrenia; Subcutaneous Absorption

Leuproreline acetate is a gonadotropin-releasing hormone (GnRH) analog which is used for in vitro fertilization (IVF) treatment. This compound suppresses gonadal estrogen secretion prior to hormonal stimulation. We report a 37-year-old woman who suffered from a schizoaffective psychosis for several years. She received IVF treatment with leuproreline acetate (Uno-Enantone) because of primary infertility. Under this treatment she developed acute schizoaffective symptoms. Suppression of gonadal secretion can result in exacerbation of schizophrenic psychosis, which is in line with the hypothesis of protective effects of estrogen in schizophrenia. We recommend that IVF treatment with leuproreline acetate in patients with psychiatric disorders be initiated only with special attention to their mental condition. In addition, patients should be informed about the possible mental effects of the treatment.

Topics: Adult; Female; Fertility Agents, Female; Fertilization in Vitro; Humans; Infertility, Female; Leuprolide; Psychoses, Substance-Induced; Psychotic Disorders

Sexually provocative and violent behavior have been reported as a result of excess androgens. We now report a temporal relationship between increased gonadotropin levels and behavioral changes in two adolescent girls who presented with a history of aggressive and bizarre sexual behavior coincident with the onset of menarche. We evaluated the possibility of a cyclical hormonal cause with daily measurements of gonadotropins, androgens and estradiol levels and correlated the results with periodic reports on the girls' behavior. We concluded that a correlation exists between periods of extremely violent and sexually provocative behavior and peaks of gonadotropin hormone secretion, even though androgen levels were normal. Treatment with medroxyprogesterone acetate (Depo-Provera) in one case and with leuprolide acetate (Lupron-Depot) in the other suppressed gonadotropin levels, and behavior improved markedly. Thus, the behavioral changes (or psychosis) seen in these girls might have been induced by increased levels of gonadotropins.

Topics: Child; Estradiol; Female; Follicle Stimulating Hormone; Humans; Leuprolide; Luteinizing Hormone; Medroxyprogesterone Acetate; Menarche; Menstruation; Psychotic Disorders; Sexual Behavior