ChatGPT Reportedly Suggests Sodium Bromide as Chloride Substitute, Leading to Bromism and Hospitalization

A 60-year-old man with no prior medical or psychiatric history presented to an emergency department with paranoid delusions, claiming his neighbor was poisoning him. After reading about the negative health effects of sodium chloride (table salt), he consulted ChatGPT about eliminating chloride from his diet. The AI system suggested that chloride could be replaced with bromide, though likely for cleaning purposes rather than dietary use. Based on this advice, the man purchased sodium bromide online and consumed it for three months as a replacement for table salt. He developed bromism (bromide toxicity) with symptoms including paranoia, auditory and visual hallucinations, facial acne, fatigue, insomnia, and excessive thirst. His bromide level was measured at 1700 mg/L (normal range 0.9-7.3 mg/L). He required a three-week hospitalization including psychiatric hold and treatment with antipsychotic medication. When the case authors tested ChatGPT 3.5 themselves, asking what chloride could be replaced with, they received a response that included bromide but provided no health warning and did not inquire about the purpose of the question. The patient fully recovered after cessation of bromide intake and appropriate medical treatment.