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Gastroenterology (Expert Forum)
Wilson's Disease and Depression
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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Wilson's Disease and Depression
by truman, May 18, 2004 12:00AM
Hi-
Is it possible for the psychiatric problems of Wilson's Disease to be treated successfully by psychiatric drugs without treating the Wilson's Disease?
My family practitioner found abnormal liver enzyme levels in routine bloodwork and suggested Wilson's as a possibility because of a recent history of severe depression, anxiety, and tics. But I improved dramatically (probably 75-80%) with several psychiatric meds and my instinct is that I have experienced 'plain old' depression and anxiety not related to some other underlying disorder.
I am hesitant to pursue further testing for Wilson's if it is unlikely, but also I am curious about this. Do psychatirc disorders that are a symptom of an underlying disease (like Wilson's) resolve with psychiatric treatment?
Your time and insight are greatly appreciated!
-C. Truman
Is it possible for the psychiatric problems of Wilson's Disease to be treated successfully by psychiatric drugs without treating the Wilson's Disease?
My family practitioner found abnormal liver enzyme levels in routine bloodwork and suggested Wilson's as a possibility because of a recent history of severe depression, anxiety, and tics. But I improved dramatically (probably 75-80%) with several psychiatric meds and my instinct is that I have experienced 'plain old' depression and anxiety not related to some other underlying disorder.
I am hesitant to pursue further testing for Wilson's if it is unlikely, but also I am curious about this. Do psychatirc disorders that are a symptom of an underlying disease (like Wilson's) resolve with psychiatric treatment?
Your time and insight are greatly appreciated!
-C. Truman
Doctor's Answer
by Kevin Pho, MD, May 18, 2004 12:00AM
, May 18, 2004 12:00AM
Approximately 10 percent of patients present with psychiatric problems ranging from subtle personality changes and deteriorating performance at school, to overt depression, paranoia, and catatonia.
There may be a possibility that the depression in your case isn't associated with Wilson's disease. To further determine this, you may want to confirm whether you have the disease or not. Patients in whom Wilson's disease is suspected should undergo initial screening with liver biochemical tests, a complete blood count, serum ceruloplasmin, 24-hour basal urinary copper, and slit-lamp examination for Kayser-Fleischer rings. You may want to discuss these tests with your personal physician.
If the depression is truly from Wilson's disease, then it would be less likely that it would respond to traditional psychiatric treatment.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Bibliography:
Kaplan. Diagnosis of Wilson's disease. UptoDate, 2004.
There may be a possibility that the depression in your case isn't associated with Wilson's disease. To further determine this, you may want to confirm whether you have the disease or not. Patients in whom Wilson's disease is suspected should undergo initial screening with liver biochemical tests, a complete blood count, serum ceruloplasmin, 24-hour basal urinary copper, and slit-lamp examination for Kayser-Fleischer rings. You may want to discuss these tests with your personal physician.
If the depression is truly from Wilson's disease, then it would be less likely that it would respond to traditional psychiatric treatment.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Bibliography:
Kaplan. Diagnosis of Wilson's disease. UptoDate, 2004.
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