PRACTITIONER’S CORNERFrom King George to Neuroglobin: The Psychiatric Aspects of Acute Intermittent PorphyriaCROARKIN, PAUL DO Author Information CROARKIN: Mental Health Services Department, Naval Medical Center, San Diego, Please send correspondence and reprint requests to: Dr. Paul Croarkin, c/o Clinical Investigation Department (KCA), Naval Medical Center San Diego, 34800 Bob Wilson Drive, Suite 5, San Diego, CA 92134-1005. The views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. Journal of Psychiatric Practice: November 2002 - Volume 8 - Issue 6 - p 398-405 Buy Abstract The porphyrias are a heterogeneous group of inherited deficiencies in the heme biosynthetic pathway. Acute intermittent porphyria is both the most prevalent and most severe form of this illness. Psychiatric symptoms are part of the classic presentation of this disorder, and psychiatric patients have a higher rate of porphyria than the general population. Despite this, clinicians often fail to consider this diagnosis in the differential for recalcitrant psychosis or depression. Many patients are asymptomatic until exposed to certain medications, liver damage, or hormonal changes. Diagnosis requires a high index of suspicion and a thorough history, physical examination, and laboratory evaluation. The author reviews historical aspects, diagnostic features, and optimal treatment of acute intermittent porphyria, considers possible etiologies of its psychiatric symptoms, and provides two case histories as examples. Copyright © 2002 Wolters Kluwer Health, Inc. All rights reserved.