Encephalopathy resembling Creutzfeldt-Jakob disease following oral, prescribed doses of bismuth nitrate.

A patient given bismuth nitrate in the recommended dose range over 16 months developed panic attacks and a major depressive syndrome and, after 15 months, a myoclonic encephalopathy resembling Creutzfeldt-Jakob disease. He recovered four months after bismuth had been discontinued. Bismuth preparations are becoming popular in the treatment of gastritis; close attention to neurological and psychiatric symptoms seems mandatory.