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Open Journal of Psychiatry & Allied Sciences
Year : 2018, Volume : 9, Issue : 2
First page : ( 164) Last page : ( 165)
Print ISSN : 2394-2053. Online ISSN : 2394-2061.
Article DOI : 10.5958/2394-2061.2018.00021.6

Pituitary adenoma with hypothalamic involvement: a case of ‘atypical’ atypical depression

Muraleedharan Manjunadh1,*, Behere Rishikesh V2

1DM Resident in Geriatric Mental Health, Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India

2Associate Professor, Department of Psychiatry, Kasturba Medical College, Manipal, Karnataka, India

*Correspondence: Dr. Manjunadh Muraleedharan, Room No. B206, Gautam Buddha Hostel, King George's Medical University, Lucknow-226003, Uttar Pradesh, India. manjunadh1987@gmail.com

Online published on 18 July, 2018.

Abstract

Pituitary tumours are known to be associated with neuropsychiatric manifestations; however, it is uncommon for the manifestations to be the sole presenting symptoms. We report a case of 29-year-old male presenting with low mood, decreased attention, forgetfulness, increased sleep, and increased appetite of three months duration. Diagnosis of moderate depression episode with atypical features was considered and started on antidepressant Bupropion up to 300 mg/day to which he showed no improvement. Considering the atypical features and poor response to antidepressants, magnetic resonance imaging (MRI) brain was done which showed pituitary macro adenoma compressing on the hypothalamus. After surgical removal of the tumour, patient's symptoms improved. Hypothalamic involvement in this patient possibly led to manifestations mimicking atypical depression. This case highlights the importance of considering organic aetiologies in patients presenting with atypical depression.

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Keywords

Neoplasms. Neuropsychiatry. Neuropsychology. Prolactinoma.

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