Encephalopathy and psychosis following administration of the combined oral contraceptive pill in an 11-year-old female.

We report herein the first case of psychosis after short-term use of the combined oral contraceptive (COC) pill in a young patient with no previous psychiatric history. An 11-year-old girl was placed on the COC pill for treatment of menorrhagia, 5 months after her menarche. She developed an initial encephalopathy, which progressed to psychosis. The estrogenic component of the COC pill is the most likely cause of this psychosis. COC pills should be used with caution in patients with an already high estrogenic state as occurs near menarche.