Bromide poisoning or bromism occurs due to excessive bromide consumption. The researchers discussed a rare case of a patient who developed bromism after taking medical guidance from ChatGPT. It is an artificial intelligence (AI) tool based on a conversational language model. Bromide poisoning shows various dermatological and neuropsychiatric symptoms, which were commonly reported during the 20th century.
Several over-the-counter (OTC) drugs containing bromide salts were responsible for psychiatric hospitalizations. From 1975 to 1989, the U.S. Food and Drug Administration (US FDA) discontinued the use of bromide. This sharp decrease in availability reduced the incidence of bromism. However, the increased use of the internet was responsible for easy access to bromide-containing drugs.
A sixty-year-old man with no prior medical or psychiatric history presented to the emergency department (ED) for poisoning. He had doubts about his neighbour. The patient did not consume any supplements or drugs. The results were normal during his physical examination and vital signs. The results of the venous blood gas test revealed metabolic and respiratory acidosis with an increased level of bicarbonates. He was transferred to a telemetry unit for further monitoring and replacement of the electrolytes.
The patient states that he filtered his water and strictly followed all dietary modifications at home. This was considered a case of pseudo-hyperchloremia based on the difference in the negative anion gap despite a normal sodium level. On his first day in the hospital, the patient experienced auditory and visual hallucinations along with significant anxiety. The physician prescribed risperidone to manage his psychosis.
Patient was medically stable in the inpatient psychiatry unit with the help of intravenous fluids and electrolyte replacement treatment. He used sodium bromide instead of sodium chloride for three months after consultation with ChatGPT. He also learned that bromide may be used as a substitute for chloride. After 21 days of stay in the hospital, his psychotic symptoms decreased, and his chloride and anion gap were noted to be normal. Risperidone was discontinued before his discharge, and two weeks later, it was observed that the patient was still stable without any medication.
The increased levels of other halides can cause ion-selective electrode tests to indicate increased chloride values falsely. Accurate diagnosis is crucial because intensive saline diuresis with intravenous normal saline may be able to reverse the toxicity once bromide administration is stopped. The ChatGPT history of the patient was not available to researchers; thus, they were not able to understand the outputs during the search results.
ChatGPT and similar AI tools may generate scientific errors and be responsible for spreading false information as AI becomes a bridge between the public and scientific knowledge in the future. It is essential to track how and where patients obtain health-related guidance from these platforms.
Reference: Eichenberger A, Thielke S, Van Buskirk A. A case of bromism influenced by use of artificial intelligence. AIM Clin Cases. 2025;4:e241260. doi:10.7326/aimcc.2024.1260
