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April 11, 1980

Paranoid Psychosis With Sulindac

Author Affiliations

Providence Hospital Southfield, Mich

JAMA. 1980;243(14):1420. doi:10.1001/jama.1980.03300400010004

To the Editor.—  Sulindac (Clinoril) is a recently marketed, nonsteroidal anti-inflammatory agent that is chemically related to indomethacin. We report a case of sulindac-associated psychosis.

Report of a Case.—  A 53-year-old, married man with a previously stable personality was well until ten days before admission to the hospital. After his first golf game of the spring, he noted painful swelling in both hands and, shortly thereafter, pain in the right knee. Roentgenograms of the hands and knee were normal.The pain and swelling persisted, and two days before admission he began receiving sulindac, 150 mg twice daily. Four hours after the first dose, the patient exhibited bizarre behavior, characterized by obsessive talking about his "inside information" concerning the Bermuda Triangle. The number "3" also held special significance for him. He demonstrated paranoid behavior, becoming distrustful of family members and being physically combative.Results of the physical examination disclosed no abnormalities