Effects of Short-term and Long-termUse of Lithium on Thyroid Hormones in Nepalese Patients with Bipolar Disorder
International Journal of Biochemistry Research & Review,
Background: Lithium has been used for decades as mood-stabilizing agents in the management of bipolar disorder and other condition with a manic component. However, some studies have also reported varying degrees of thyroid abnormalities associated with lithium therapy and effect of such therapy on thyroid function is unclear in this part of world. Therefore, we aimed to determine the effect of long term use of lithium on thyroidfunctionin the individual with bipolar disorder receiving lithium therapy.
Methods: A total of 75 bipolar disorder patients (24 males, 51 females) who are under lithium therapy and equal number of control were recruited for this study. Diagnosis of bipolar disorder was made by psychiatrist according to ICD-10-DCR guidelines and DSM-IV criteria. Serum fT3, fT4 and TSH were measured by enhanced chemiluminescence immunoassay. Statistical analysis was performed using SPSS 20.0 version.
Results: The prevalence of primary hypothyroidism and subclinical hypothyroidism were found significantly increased in lithium treated group (12% and 17%, respectively) which was further increased with duration of treatment. The mean fT3 and fT4 concentration is low in lithium treated group compared to control group.Butmean TSH level was found significantlyhigher in lithium treated group compared to control (9.67±12.47 vs. 3.41±3.69, p<0.005).
Conclusion: Our findings indicate that use of lithium therapy is associated with higher degree of primary hypothyroidism and subclinical hypothyroidism and female are more susceptible for the thyroid dysfunction associated with lithium therapy.
- Bipolar disorder
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Goodwin F, Jamison K. Suicide, in manic-depressive illness. New York. Oxford University; 1990.
Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry. 1994;51(1):8-19.
Wang PW, Ketter TA. Pharmacokinetics of mood stablizers and new anticonvulsants. Psychopharmacol Bull. 2002;36:44-66
Bauer M, Severus E, Möller HJ, Young AH. WFSBP task force on unipolar depressive disorders. Pharmacological treatment of unipolar depressive disorders: summary of WFSBP guidelines. Int J Psychiatry Clin Pract. 2017;21(3):166-176.
Goodwin FK, Fireman B, Simon GE, Hunkeler EM, Lee J, Revicki D. Suicide risk in bipolar disorder during treatment with lithium and divalproex. Jama. 2003;290(11):1467-73.
Wyatt RJ, Henter ID, Jamison JC. Lithium revisited: savings brought about by the use of lithium, 1970–1991. Psychiatric Quarterly. 2001;72(2):149-66.
Hiemke C, Bergemann N, Clement HW, Conca A, Deckert J, Domschke K, Eckermann G, Egberts K, Gerlach M, Greiner C, Gründer G, Haen E, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: Update 2017. Pharmacopsychiatry. 2018;51(1-02):9-62.
Mallette LE, Eichhorn E. Effects of lithium carbonate on human calcium metabolism. Archives of internal Medicine. 1986;146(4):770-6.
Kallner G, Petterson U. Renal, thyroid and parathyroid function during lithium treatment: laboratory tests in 207 people treated for 1–30 years. Acta Psychiatrica Scandinavica. 1995;91(1):48-51.
Christiansen C, Baastrup P, Lindgreen P, Transbøl I. Endocrine effects of lithium. Acta Endocrinologica. 1978;88(3):528-34.
Kleiner J, Altshuler L, Hendrick V, Hershman JM. Lithium-induced subclinical hypothyroidism: review of the literature and guidelines for treatment. The Journal of Clinical Psychiatry. 1999; 60(4):249-55.
Bhandari S. Lithium-induced hypothyroidism. The British Journal of Psychiatry. 2000;176(1):95.
Johnston A, Eagles J. Lithium-associated clinical hypothyroidism. Prevalence and risk factors. The British Journal of Psychiatry. 1999;175(4):336-9.
Sanad MH, Salama DH, Marzook FA. Radioiodinated famotidine as a new highly selective radiotracer for peptic ulcer disorder detection, diagnostic nuclear imaging and biodistribution. Radiochim Acta. 2017;105(5):389‐398.
Sanad MH. Labeling of omeprazole with technetium‐99m for diagnosis of stomach. Radiochemistry. 2013;55(6):605‐609.
Sanad MH, Ibrahim IT. Radiodignosis of peptic ulcer with technetium ‐99m pantoprazole. J Radiochemistry. 2013;55(3):341‐345.
Sanad MH, Ibrahim IT. Radiodiagnosis of peptic ulcer with technetium‐99m labeled rabeprazole. Radiochemistry. 2015; 57(4):425‐430.
Sanad MH, Challan SB. Radioiodination and biological evaluation of rabeprazole as a peptic ulcer localization radiotracer. Radiochemistry. 2017;59(3):307‐312.
Sanad MH, Farag AB, Dina HS. J. Radioiodination and bioevaluation of rolipram as a tracer for brain imaging: In silico study, molecular modeling and gamma scintigraphy Label Compd. Radiopharm. 2018;61:50.
Sanad MH, Saleh GM, Marzook FA. Radioiodination and biological evaluation of nizatidine as a new highly selective radiotracer for peptic ulcer disorder detection. J. Label. Compd. Radiopharm. 2017;60:600.
Borai EH, Sanad MH, Fouzy ASM. Optimized chromatographic separation and biological evaluation of 99mTc-clarithromycin for infective inflammation diagnosis. Radiochemistry. 2016; 58:84.
Sanad MH, Marzook F, Saleh GM, Farag AB, Talaat HM. Radiolabeling, preparation, and bioevaluation of 99mTc-azathioprine as a potential targeting agent for solid tumor imaging. Radiochemistry. 2019; 61(4):478.
Sanad MH, Farag AB, Saleh GM. Radiosynthesis and biological evaluation of 188Re-5,10,15,20 –Tetra (4-pyridyl)- 21H,23H -porphyrin complex as a tumor-targeting agent. Radiochemistry. 2019; 61(3):347.
Sanad MH, Abelrahman M.A., Marzook, F.M.A. Radioiodination and biological evaluation of levalbuterol as a new selective radiotracer: A β2-adrenoceptor agonist. Radiochimica Acta. 2016;104(5):345.
Sanad MH, Ibrahim AA, Talaat HM. Synthesis, bioevaluation and gamma scintigraphy of 99mTc-N-2-(Furylmethyl iminodiacetic acid) complex as a new renal radiopharmaceutical. Journal of Radioanalytical and Nuclear Chemistry. 2018;315(1):57.
Sanad, H.M., Ibrahim, A.A. Radioiodination, diagnostic nuclear imaging and bioevaluation of olmesartan as a tracer for cardiac imaging. Radiochimica Acta. 2018;106(10):843.
First M, Spitzer R, Gibbon M, Williams J. Structured Clinial Interview for DSM-IV-R Axis I Disorders (SCID-I), Clinican Version, Users Guide. Arlington: Amer Psychiatric Pub Inc.; 1996.
Organization WH. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines: Geneva: World Health Organization; 1992.
Kirov G, Tredget J, John R, Owen MJ, Lazarus JH. A cross-sectional and a prospective study of thyroid disorders in lithium-treated patients. Journal of Affective Disorders. 2005;87(2):313-7.
Kraszewska A, Chlopocka‐Wozniak M, Abramowicz M, Sowinski J, Rybakowski JK. A cross‐sectional study of thyroid function in 66 patients with bipolar disorder receiving lithium for 10–44 years. Bipolar Disorders; 2014.
Henry C. Lithium side-effects and predictors of hypothyroidism in patients with bipolar disorder: sex differences. Journal of Psychiatry and Neuroscience. 2002;27(2):104.
Berens SC, Wolff J & Murphy DL. Lithium concentration by the thyroid. Endocrinology. 1970; 87:1085–1087.
Pfeifer WD, Davis LC & Van der Velde CD. Lithium accumulation in some endocrine tissues. Acta Biologica et Medica Germanica. 1976;35:1519–1523.
Lazarus JH. Lithium and thyroid. Best Pract Res Clin Endocrinol Metab. 2009;23(6):723-33.
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