Fifteen-year follow-up of thyroid function in lithium patients

Bocchetta, Alberto; Cocco, Francesca; Velluzzi, Fernanda; Zompo, Maria Del; Mariotti, Stefano; Loviselli, Andrea

doi:10.1007/bf03346311

Cited by 65 publications

(52 citation statements)

References 19 publications

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“…31 In a 15-year follow-up study of Bocchetta et al, yearly hypothyroidism ratio was found at 1.5% in lithium-treated bipolar patients. 32 No patients devel- Under the light of our findings, it may be suggested that lithium treatment is safe in patients who stayed euthyroid when using lithium and treatment may be continued by doing required tests. Increased thyroid volume on ultrasonography is an expected finding in patients who have been using lithium for a long time.…”

Section: Discussionmentioning

confidence: 70%

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: Discussionmentioning

confidence: 70%

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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“…Figure 1 presents the clinical comorbidities exhibited by studied patients, where the most commonly observed ones were: hypertension (50%), obesity (46.4%), hypothyroidism (39.3%), and gastric problems (32.1%). It is known that bipolar patients are more susceptible to clinical comorbidities (Angst et al, 2000) and many of these could be due to utilized medications, such as hypothyroidism (Bocchetta et al, 2007) and obesity (Ketter, Haupt, 2006;Garcia-Portilla et al, 2008). It is also known that lithium and valproate could lead to hypothyroidism, and that mood stabilizers and antipsychotics could lead to obesity.…”

Section: Resultsmentioning

confidence: 99%

Pilot-project of implantation of pharmaceutical care close to the program of bipolar mood disorder of the Hospital of Clinics of Porto Alegre

Ceresér¹,

Mascarenhas²,

Santin³

et al. 2009

Braz. J. Pharm. Sci.

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The Bipolar Mood Disorder is characterized by the alternation of depressive crises with episodes of mania or euphoria, having these patients 15 to 35 times more chances of suicide, as compared with people without this disorder. The pharmacotherapy is fundamental for this disease, aiming to decrease the frequency of episodes and disease severity. In these patients, the polypharmacy has recently increased and one of the main difficulties is the adherence to treatment. The objective of this study was to contribute for the improvement of bipolar patients health conditions, developing their respective pharmacotherapeutic follow-up. Twenty eight adult bipolar patients who were participants of a specialized clinic within a tertiary hospital in Porto Alegre have been randomly selected, and the Dader Method of pharmacotherapeutic follow-up has been applied. The more common clinical comorbidities were: hypertension (50%), obesity (46.43%), and hypothyroidism (36.29%). The bipolar patients are more susceptible to clinical comorbidities, and many of them could be due to pharmacotherapy. Only 1.43% of patients presented Drug Related Problems, being all of them resolved along the study. It was also observed that 32.14% of evaluated patients presented low adherence to treatment, and between these patients, 55.56% passed to have good adherence after pharmacotherapeutic follow-up. The pharmacotherapeutic follow-up is fundamental for the improvement of patient's health. New studies, with higher number of patients and longer duration, are necessary to evaluate the percentage of patients that could be beneficiary of Pharmaceutical Care.
O Transtorno do Humor Bipolar é caracterizando pela alternância de crises depressivas com episódios de mania ou euforia, tendo estes pacientes 15-35 vezes mais chances de suicídio em comparação com pessoas sem este transtorno. A farmacoterapia é fundamental, visando diminuir a freqüência dos episódios e a gravidade da doença. Nestes pacientes, a polifarmácia tem aumentado ultimamente e uma das maiores dificuldades é a adesão ao tratamento. O objetivo do estudo foi contribuir para a melhoria das condições de saúde de pacientes bipolares, realizando o acompanhamento farmacoterapêutico dos mesmos. Foram selecionados aleatoriamente 28 pacientes bipolares adultos, participantes de um ambulatório especializado de um hospital terciário em Porto Alegre e aplicado o Método Dáder de acompanhamento farmacoterapêutico. As co-morbidades clínicas mais comuns foram: hipertensão (50%), obesidade (46,43%) e hipotiroidismo (39,29%). Os pacientes bipolares são mais suscetíveis a co-morbidades clínicas e muitas destas podem ser devidas a farmacoterapia. Apenas 1,43% dos pacientes apresentavam Problemas Relacionados a Medicamentos, sendo todos solucionados no decorrer do estudo. Também se observou que 32,14% dos pacientes avaliados apresentavam baixa adesão ao tratamento e entre estes, 55,56% passaram a ter boa adesão após o acompanhamento farmacoterapêutico. É fundamental para a melhoria da saúde do paciente o acompa...

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“…The occurrence of newer thyroid antibodies is more in a state of long term lithium intake because it augments the activity of B lymphocytes and reducing the ratio of circulating suppressor to cytotoxic T cells. The presence of thyroid antibody in lithium induced hypothyroidism requires supplementation of thyroxine [3,4]. Other risk factors for lithium induced hypothyroidism are older age, longer duration of drug intake, female sex, and co-existing iodine deficiency [5].…”

Section: Parametersmentioning

confidence: 99%

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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Fifteen-year follow-up of thyroid function in lithium patients

Abstract: Lithium may be associated with hypothyroidism in particular in the presence of circulating thyroid antibodies. Incidence of thyroid antibodies is comparable with that reported for the general population. Hyperthyroidism and thyroid cancer are rare.

Cited by 65 publications

References 19 publications

Pilot-project of implantation of pharmaceutical care close to the program of bipolar mood disorder of the Hospital of Clinics of Porto Alegre

Preventable coma- Lithium induced !

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