Objective. A case is reported of an acute paranoid syndrome in the course of Cushing 's disease caused by hypophysial adenoma.
Case. A female patient aged 24, hospitalisedfor an acute paranoid syndrome after several months of Cushing 's syndrome. She was treated with drugs lowering the cortisol level, and without improvement - with haloperidol andfluphenzine. Subsequent treatment with clozapine was very effective. After resection of the hypophysial adenoma no relapse of the psychotic disorder was noted. In the patient 's family there were cases of not only hypophysial adenoma, but also mental disorders.
Commentary. Clozapine treatment associated with neurosurgical intervention may be effective in patients with an acute paranoid syndrome in the course of Cushing's disease.