Six‐year follow‐up of thyroid function during lithium treatment

Bocchetta, Alberto; Cherchi, A.; Loviselli, Andrea; Mossa, P; Velluzzi, Fernanda; Derai, R.; Zompo, Maria Del

doi:10.1111/j.1600-0447.1996.tb09823.x

Cited by 31 publications

(17 citation statements)

References 22 publications

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“…Lithium might not be the only cause of hypothyroidism in bipolar patients. Studies exploring thyroid autoimmunity found that thyroperoxidase antibodies were highly prevalent in both bipolar men and women (Kupka et al, 2002) and not associated with lithium treatment (Bocchetta et al, 1996;Kupka et al, 2002), suggesting that autoimmunity and lithium exposure are two independent but cumulative risk factors for hypothyroidism in patients with bipolar disorder and women are more at risk for hypothyroidism than men.…”

Section: Do Treatment Response and Side Effects Differ Between Genders?mentioning

confidence: 98%

Is sex important? Gender differences in bipolar disorder

DiFlorio

Jones

2010

International Review of Psychiatry

247

164

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Sex is clearly important in unipolar mood disorder with compelling evidence that depression is approximately twice as common in women than in men. In the case of bipolar disorder, however, it is widely perceived that the reported equal rate of illness in men and women reflects no important gender distinctions. In this paper we review the literature on gender differences in bipolar illness and attempt to summarize what is known and what requires further study. Despite the uncertainties that remain some conclusions can be drawn. Most studies, but not all, report an almost equal gender ratio in the prevalence of bipolar disorder but the majority of studies do report an increased risk in women of bipolar II/hypomania, rapid cycling and mixed episodes. Important gender distinctions are also found in patterns of co-morbidity. No consistent gender differences have been found in a number of variables including rates of depressive episodes, age and polarity of onset, symptoms, severity of the illness, response to treatment and suicidal behaviour. Unsurprisingly, however, perhaps the major distinction between men and women with bipolar disorder is the impact that reproductive life events, particularly childbirth, have on women with this diagnosis.

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Section: Do Treatment Response and Side Effects Differ Between Genders?mentioning

confidence: 98%

Is sex important? Gender differences in bipolar disorder

DiFlorio

Jones

2010

International Review of Psychiatry

247

164

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“…In a follow-up study by Lombardi et al (26) at the end of one year, goiter developed in half of 12 patients who had newly started lithium treatment; the appearance of nodular lesions was detected in two of these patients. In the study by Bocchetta et al (27) which assessed 67 lithium-treated patients, goiter was detected in 39% of the patients, hypoechogenicity was detected in 54% of the patients, a non-homogeneous pattern was detected in 40% of the patients, and nodules were detected in 28% of the patients. In a study by Loviselli et al (11) which assessed 23 lithium-treated patients, development of goiter was detected in only 1 of the 15 patients who had normal thyroid USG results before lithium treatment; no significant volumetric changes were observed in patients who had goiter prior to lithium treatment.…”

Section: Introductionmentioning

confidence: 99%

Thyroid Function and Ultrasonography Abnormalities in Lithium-Treated Bipolar Patients: A Cross-sectional Study with Healthy Controls

Tunçel

Akdeniz

Özbek

et al. 2017

Arch Neuropsychiatr

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Introduction: Lithium has many effects on thyroid physiology. Although these side effects have been known for a long time, large sample studies of lithium-treated patients using ultrasonography are lacking. The aim of this study is to investigate the detailed thyroid morphologies, hormone levels, and antibodies of lithium-treated patients compared with healthy controls.Methods: This cross-sectional study involved 84 lithium-treated patients with bipolar disorder and 65 gender and age similar controls who had never been exposed to lithium. Subjects between 18 and 65 years of age were eligible for the study. Venous blood samples were acquired to determine the levels of free thyroxine (fT4), thyroid stimulating hormone (TSH), and thyroid antibodies; also, ultrasonographic examinations of the patients' thyroid glands were performed.Results: There were no statistically significant differences in smoking habits, known thyroid disease, thyroid medication use, familial thyroid disease, fT4 level, autoimmunity, thyroid nodule presence, or Hashimoto' s thyroiditis between the lithium and control groups. The median TSH level and thyroid volume were significantly higher in the lithium group. In the lithium group, 14 cases (16.7%) of hypothyroidism, seven cases (8.3%) of subclinical hypothyroidism, and one case (1.2%) of subclinical hyperthyroidism were defined; in the control group, seven cases (10.8%) of hypothyroidism and two cases (3.1%) of subclinical hyperthyroidism were defined. Thyroid dysfunction, goiter, parenchymal abnormality, ultrasonographically defined thyroid abnormality, and thyroid disorder were found to be more prevalent in the lithium group. 90% of patients with goiter and 74.3% of patients with ultrasonographic pathologies were euthyroid. Conclusion:It is important to note that 90% of the patients with goiter were euthyroid. This indicates that monitoring by blood test alone is insufficient. The prevalence rates of 47.6% for goiter and 83.3% for ultrasonographic pathology demonstrate that ultasonographic follow-up may be useful in lithium-treated patients. To determine whether routine ultrasonographic examination is necessary, large sample prospective studies are necessary due to the limitations of this study.

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“…In some patients, lithium inhibits thyroid hormone release and induces goitre 15. However, clinical hypothyroidism is no more frequent in patients on lithium therapy than in the general population and is more likely to develop in those who are already at risk (e.g.…”

Section: Unwanted Effectsmentioning

confidence: 99%

“…However, clinical hypothyroidism is no more frequent in patients on lithium therapy than in the general population and is more likely to develop in those who are already at risk (e.g. women rather than men, and patients with antithyroid antibodies) 15. Thyroid function should be checked annually unless there is evidence of affective relapse or clinical features of hypothyroidism.…”

Section: Unwanted Effectsmentioning

confidence: 99%

Using lithium safely

1999

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Six‐year follow‐up of thyroid function during lithium treatment

Cited by 31 publications

References 22 publications

Is sex important? Gender differences in bipolar disorder

Is sex important? Gender differences in bipolar disorder

Thyroid Function and Ultrasonography Abnormalities in Lithium-Treated Bipolar Patients: A Cross-sectional Study with Healthy Controls

Using lithium safely

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