Sertraline alleviated osmophobia caused by partial hypopituitarism with isolated ACTH deficiency

Gen Hosp Psychiatry. 2013 Sep-Oct;35(5):574.e9-10. doi: 10.1016/j.genhosppsych.2012.07.008. Epub 2012 Aug 15.

Abstract

Objective: Hyperosmia may be an early manifestation of hypocortisolism and may be mistakenly diagnosed as osmophobia. However, sertraline therapy incidentally alleviated the phobic symptoms and hindered accurate diagnosis.

Case report: A 41-year-old man was diagnosed as having osmophobia. Initial sertraline treatment relieved the symptoms, but its cessation resulted in recurrence of osmophobia. Endocrinological examinations revealed severe hypocortisolism and partial hypopituitarism with isolated adrenocorticotropic hormone deficiency. After prednisolone supplementation, his condition dramatically improved.

Conclusion: We recommend that, before intervention with selective serotonin reuptake inhibitors is performed, the hypothalamic-pituitary-adrenal axis be evaluated in psychiatric patients presenting with co-occurring olfactory change.

Keywords: Hyperosmia; Hypocortisolism; Hypopituitarism; Osmophobia; Selective serotonin reuptake inhibitor.

Publication types

  • Case Reports

MeSH terms

  • Adrenocorticotropic Hormone / deficiency*
  • Adult
  • Endocrine System Diseases / complications
  • Endocrine System Diseases / drug therapy*
  • Genetic Diseases, Inborn / complications
  • Genetic Diseases, Inborn / drug therapy*
  • Glucocorticoids / therapeutic use
  • Humans
  • Hypoglycemia / complications
  • Hypoglycemia / drug therapy*
  • Hypopituitarism / complications
  • Hypopituitarism / drug therapy*
  • Male
  • Odorants*
  • Phobic Disorders / drug therapy*
  • Prednisolone / therapeutic use
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Sertraline / therapeutic use*

Substances

  • Glucocorticoids
  • Serotonin Uptake Inhibitors
  • Adrenocorticotropic Hormone
  • Prednisolone
  • Sertraline

Supplementary concepts

  • ACTH Deficiency, Isolated