A Case Report of Opioid Induced Hypomania and Obsessive Compulsive Disorder

Obsessive compulsive disorder (OCD) and bipolar disorder are common psychiatric illnesses and there are many challenges in pathology and their treatment. In recent years, the role of opioid system in the pathology of these disorders has been considered. In this report, we present a case with simultaneous episodes of hypomania and OCD following opium use. The 65-year-old man, who was suffering from irritability, talkativeness, over spending and frequent washing following use of opium, visited in psychiatric clinic. After administration of 30 mg of methadone every day, all her symptoms improved. During 12 years of follow-up, we observed that her symptoms recurred when the patient was taking opium again. Few days after repeat prescription of methadone, these symptoms subsided. The findings of this study emphasize the role of opioid system in the pathology of obsessive-compulsive disorder and bipolar disorder, at least when there are comorbid.