A man began hearing voices from his body parts after receiving testosterone injections
A recent case report details how a 45-year-old man developed severe religious delusions and hallucinations after receiving prescribed testosterone injections. His undiagnosed genetic condition may have increased his vulnerability to these rare psychiatric side effects.
A man developed severe psychiatric symptoms, such as hallucinations and delusions, after receiving testosterone injections for a year, according to a recent case report. The patient's underlying genetic condition, Klinefelter syndrome, may have made him especially vulnerable to these side effects. Published in The Primary Care Companion for CNS Disorders by psychiatrists Abhijeet Anand and Shobit Garg, the report explains the intersection of medical and psychiatric conditions.
Klinefelter syndrome, where males are born with an extra X chromosome (resulting in an XXY pattern), affects physical development and fertility. Men with this syndrome often have smaller testes, reduced body and facial hair, and other physical characteristics. Doctors prescribe testosterone therapy to help replace hormones that the body does not produce in sufficient quantities, improving bone density, muscle strength, and energy levels.
While the physical side effects are well-known, their impact on the brain, such as influencing the limbic system and altering brain chemicals like dopamine and glutamate, is less understood. This disruption can potentially cause mood disturbances or psychosis. The psychiatric side effects of extreme doses, commonly seen in athletes, are well-documented.
However, therapeutic doses prescribed by doctors are generally considered safe for mental health. The report highlights that even these monitored medical treatments can sometimes trigger severe mental health crises in susceptible patients. The case involves a 45-year-old married man who experienced sudden unusual behavior, intense religious beliefs, suspiciousness, and hearing voices.
He had been infertile for 15 years and had low testosterone, which was not treated until the onset of his psychiatric crisis. After receiving monthly intramuscular testosterone injections for a year, his symptoms worsened. Doctors diagnosed him with Klinefelter syndrome and substance-induced psychotic disorder due to the steroid therapy.
Upon stopping the testosterone injections and starting antipsychotic medications, his symptoms improved significantly.
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