Mania in Hyperandrogenism, Insulin Resistance, and Acanthosis Nigricans Syndrome

The document from 2002 reported a case of a 19-year-old woman with Hyperandrogenism, Insulin Resistance, and Acanthosis Nigricans (HAIR-AN) syndrome who experienced her first manic episode after discontinuing her birth control pills. The patient's symptoms included elevated mood, lessened need for sleep, racing thoughts, pressured speech, and grandiose delusions. Her physical examination revealed a male pattern of hair growth on her face and hyperpigmented skin on the neck. Endocrinological tests confirmed the diagnosis of HAIR-AN syndrome with elevated insulin and testosterone levels. The patient's manic symptoms were successfully treated with lithium, divalproex sodium, and quetiapine. The document suggested that this might be the first documented case of mania in a patient with HAIR-AN syndrome, and the manic symptoms emerged 2 months after she stopped treatment with oral contraceptives. However, the authors noted that further study was needed to confirm the association.