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On the Prevalence, Diagnosis and Management of Lithium-Induced Hypothyroidism in Psychiatric Patients

Published online by Cambridge University Press:  29 January 2018

Göran Lindstedt
Affiliation:
University of Göteborg, Department of Clinical Chemistry, Sahlgren's Hospital, S-413 45 Göteborg, Sweden
Lars-Åke Nilsson
Affiliation:
University of Göteborg, Institute of Medical Microbiology, S-413 46 Göteborg, Sweden
Jan Walinder
Affiliation:
University of Göteborg, Psychiatric Research Centre, St. Jörgen's Hospital, S-422 03 Hisings Backa, Sweden
Annika Skott
Affiliation:
University of Göteborg, Psychiatric Research Centre, St. Jörgen's Hospital, S-422 03 Hisings Backa, Sweden
Rolf Öhman
Affiliation:
University of Göteborg, Lillhagen's Hospital, S-422 03 Hisings Backa, Sweden

Summary

Fifty-three psychiatric patients who had been receiving treatment with lithium continuously for more than two years were examined to estimate the prevalence of lithium-induced hypothyroidism. It was found to be 20 per cent among women. No men were affected among these patients. In order to study the characteristics of the disorder further cases were drawn from another population. One third of the patients developed hypothyroidism during their first year of treatment, others not until after 9 years. About two thirds of the female patients with hypothyroidism had thyroid antibodies. All cases with lithium-induced hypothyroidism showed elevated levels of serum thyrotropin, which in our experience is the laboratory examination of choice in these as well as other cases of ‘primary’ hypothyroidism. Since the probability of detecting these cases at a given control visit was found to be low, we feel that such visits need not include extensive laboratory investigations. Hypothyroid patients responding well to lithium treatment should continue their medication combined with appropriate thyroxine substitution.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1977 

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