Differences in hypothyroidism between lithium-free and -treated patients with bipolar disorders

Zhang, Zhang-Jin; Li, Qiang; Kang, Wan-Hu; Tan, Qingrong; Gao, Chengge; Zhang, Feng-Gang; Wang, Huaihai; Ma, Xiancang; Chen, Ce; Wang, Wei; Guo, Li; Ya-hong, Zhang; Yang, Xiao; Zhang, Ruiguo

doi:10.1016/j.lfs.2005.05.090

Cited by 20 publications

(10 citation statements)

References 29 publications

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“…22 Zhang et al found that TSH levels increased with time in lithium-treated patients. 37 In our study, TSH levels tended to elevate in oneyear follow-up and this elevation was not found to be correlated with lithium level. Increase in TSH levels indicates the significance of follow-up of this parameter although it stayed within normal ranges.…”

Section: Discussioncontrasting

confidence: 62%

Thyroid status in lithium-treated bipolar disorder patients: An one-year follow-up study - Estudio de un año de seguimiento del estado de la tiroides en pacientes con trastorno bipolar tratados con litio Estudio de un año de seguimiento del estado de la tiroides en pacientes con trastorno bipolar tratados con litio)

et al. 2014

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SUMMARY ObjectiveIn this follow-up study, the hormonal changes were determined in bipolar euthyroid patients who were treated with lithium for the duration of one year. MethodFor the study, 23 bipolar I disorder patients without any axis I comorbidity were consecutively selected and followed up for one year. All patients were compared with 25 age-and sex-matched healthy controls in terms of thyroid hormone levels and thyroid volumes. The Sociodemographic and Clinical Characteristics Data Form, Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I and SCID-I/NP) were administered. Initial thyroid hormone levels and thyroid volumes were measured in the patients and controls. Patient and control groups were compared at baseline for thyroid volumes. Patients' lithium levels were measured at baseline, they were re-examined at six months for thyroid hormones, and at the first year for thyroid hormones and lithium levels. ResultsThyroid hormone levels changed in no patients during the follow-up period. Thyroid hormone levels were measured within the normal range. No correlation was found between the final TSH levels and duration of illness, duration of lithium treatment, initial thyroid volumes, and the initial TSH levels. ConclusionsLithium can safely be used in bipolar patients who were already receiving this treatment before and not developed any thyroid problem for a substantial period.Key words: Lithium, thyroid gland, bipolar disorder. RESUMEN ObjetivoEn este estudio de seguimiento se determinarán los cambios hormonales que se producen en pacientes eutiroideos con trastorno bipolar en tratamiento con litio durante un periodo de un año. MétodoPara el estudio se seleccionaron de forma consecutiva 23 pacientes con trastorno bipolar tipo I sin prevalencia concomitante de otros trastornos del eje I, y fueron seguidos durante un año. En todos los pacientes se compararon los niveles de las hormonas tiroideas y el volumen de la glándula tiroides con las del grupo control sano pareado por sexo y compuesto de sujetos de 25 años de edad. La evaluación se hizo por medio de: una hoja de datos de las características sociodemográficas y clínicas, la Escala de Valoración de Hamilton para la Evaluación de la Depresión (HDRS), la Escala de Young para la Evaluación de la Manía (YMRS), Entrevistas clínicas estructuradas para los trastornos del eje I del DSM-IV (SCID-I y SCID-I/NP). A los pacientes y al grupo control se les midieron los niveles iniciales de las hormonas tiroideas y el volumen de la glándula tiroides, a la vez que se les comparó la línea base del volumen de la glándula tiroides. Al inicio del estudio se determinó la línea base de los niveles de litio en los pacientes. Al sexto mes, se reexaminaron las hormonas tiroideas y, al cabo del primer año, los niveles hormonales tiroideos y de litio. ResultadosLos niveles de las hormonas tiroideas no sufrieron cambios en ningún paciente durante todo el seguimiento. Dichos niveles se midieron ...

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Section: Discussioncontrasting

confidence: 62%

Thyroid status in lithium-treated bipolar disorder patients: An one-year follow-up study - Estudio de un año de seguimiento del estado de la tiroides en pacientes con trastorno bipolar tratados con litio Estudio de un año de seguimiento del estado de la tiroides en pacientes con trastorno bipolar tratados con litio)

et al. 2014

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“…These observations suggest that the development of hypothyroidism, regardless of etiology, may increase the risk of the rapid cycling variant in bipolar individuals. Subsequent studies have confirmed this …”

Section: Introductionmentioning

confidence: 59%

“…Subsequent studies have confirmed this. [13][14][15] This association between the hypothyroid state and the rapid cycling bipolar phenotype first prompted the use of thyroid hormone as an adjunct to pharmacologic treatment in those individuals with refractory disease. In an open-label study, the addition of high-dose (supra-physiologic) levothyroxine (L-T 4 ) to a stable therapeutic regimen of mood-stabilizing drugs in rapid cycling bipolar disorder was associated with improvements in depressive symptoms in 10 out of 11 patients and a reduction in manic symptoms in five out of seven patients.…”

mentioning

confidence: 99%

Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T₄) and triiodothyronine (T₃)

et al. 2018

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“…Parenteral levothyroxine supplementation under steroid cover should be considered in severe lithium induced hypothyroidism. Hypothyroidism due to lithium involve low T3, in contrast to low T4 in lithium free state [7].…”

Section: Parametersmentioning

confidence: 91%

Preventable coma- Lithium induced !

Natarajan¹,

Asha²,

Behra³

et al. 2015

JCR

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Abstract:Lithium is the one of the drugs of choice for manic depressive illness. Lithium practice guidelines should be followed for every patient before initiating them on lithium therapy. Here we report a case of elderly man with manic depressive illness, who was prescribed lithium, lost follow-up and presented with lithium toxicity-hypothyroidism, nephrogenic diabetes insipidus, sinus node dysfunction. He was managed with parenteral levothyroxine under steroid cover, multiple sessions of hemodialysis and improved. This case report emphasizes the importance of lithium practice guidelines and the responsibility of prescriber to prevent such an event.

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Differences in hypothyroidism between lithium-free and -treated patients with bipolar disorders

Cited by 20 publications

References 29 publications

Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T₄) and triiodothyronine (T₃)

Preventable coma- Lithium induced !

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Differences in hypothyroidism between lithium-free and -treated patients with bipolar disorders

Cited by 20 publications

References 29 publications

Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T4) and triiodothyronine (T3)

Preventable coma- Lithium induced !

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Adjunctive thyroid hormone treatment in rapid cycling bipolar disorder: A double‐blind placebo‐controlled trial of levothyroxine (L‐T₄) and triiodothyronine (T₃)