Adrenal gland anxiety8/30/2023 Opiates can cause hypothalamic suppression of corticotrophin-release hormone and, therefore, adrenocorticotropic hormone (ACTH) with resultant adrenal atrophy. Another less-often considered and rarer cause for secondary adrenal insufficiency is use of opiate medication, a commonly prescribed class of painkillers in both hospital and general practice settings. There are several known causes of secondary adrenal insufficiency, although it is most commonly associated with an abrupt disruption in prescribed corticosteroid therapy (such as during an emergency hospital admission). 2 These psychiatric symptoms may even present with no physical symptoms. 1 Adrenal insufficiency is notoriously challenging to diagnose, with up to 60% of patients having been seen by at least 2 clinicians prior to diagnosis and a median duration to diagnosis of up to 2 years. To the Editor: Adrenal insufficiency has been shown to display a wealth of possible psychiatric presentations including psychosis, depression, anxiety, mania, and cognitive impairment, alongside the known vague physical symptoms.
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