HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Thyroid function and psychiatric morbidity in patients with manic disorder receiving lithium therapy.

Abstract
Euthyroid hyperthyroxinemia as a result of a transient increase in thyroid-stimulating hormone (TSH) levels may contribute to the development of manic disorder. Lithium has a potent short-term antithyroidal effect that may account for its antimanic action. The thyroid function and psychiatric morbidity of 46 adult patients with manic disorder were assessed prospectively before and 1 and 6 months after lithium treatment. At baseline, the free thyroxine level (FT4, 16.23 +/- 3.11 pmol/L) was at the high end of the normal range, whereas the free triiodothyronine (FT3, 4.24 +/- 0.65 pmol/L) and TSH (1.47 +/- 0.73 mIU/L) levels were within the normal range. All patients were clinically euthyroid, but five of them (11%) had elevated FT4 levels. Baseline FT3 and FT4 levels were positively correlated with past psychiatric morbidity. The FT4 level at baseline and after 1 month of treatment was positively correlated with scores on the Brief Psychiatric Rating Scale (p < 0.02) and negatively correlated with scores on the Global Assessment Scale (p < 0.005). During the first month of treatment, the reduction of FT3 and FT4 levels was significantly correlated with a decrease in psychiatric symptoms. By 6 months, the FT3 level was no longer significantly different from that at the baseline, but FT4 levels remained significantly lower. The TSH level increased progressively from baseline to 6 months. Multilevel models showed that FT4 and serum lithium levels were positively and negatively associated with psychiatric symptoms, respectively. The findings of the study lend support to the notion that euthyroid hyperthyroxinemia contributes to acute mania and suggest that lithium's short-term antimanic action may be mediated by its antithyroid effect.
AuthorsS Lee, C C Chow, Y K Wing, A C Shek, T W Mak, A Ahuja, D T Lee, T Y Leung
JournalJournal of clinical psychopharmacology (J Clin Psychopharmacol) Vol. 20 Issue 2 Pg. 204-9 (Apr 2000) ISSN: 0271-0749 [Print] United States
PMID10770459 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antimanic Agents
  • Triiodothyronine
  • Lithium Carbonate
  • Thyrotropin
  • Thyroxine
Topics
  • Adult
  • Antimanic Agents (adverse effects, therapeutic use)
  • Bipolar Disorder (blood, drug therapy, psychology)
  • Euthyroid Sick Syndromes (blood, drug therapy, psychology)
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthyroxinemia (blood, drug therapy, psychology)
  • Lithium Carbonate (adverse effects, therapeutic use)
  • Male
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Thyroid Function Tests
  • Thyrotropin (blood)
  • Thyroxine (blood)
  • Triiodothyronine (blood)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: