Journal of Organic & Inorganic Chemistry

Effects of Short-term and Long-term Use of Lithium on Thyroid Function Tests in Patients with Bipolar Disorder

Background
Lithium has been used by most psychiatrists as a long term effective therapy for the treatment of bipolar disorder as well as reducing the
risk of suicide and short term mortality in patients. However, some studies have also reported varying degrees of thyroid abnormalities in
lithium treated patients, but it is unclear whether there is significant association with duration of therapy. We aimed to determine the effect
of long term use of lithium on thyroid function tests and possible prevalence of hypothyroidism in women and men with bipolar disorder.
Methods:
This cross-sectional study was conducted in 75 bipolar disorder patients (24 males, 51 females) treated with lithium and equal number of
controls. 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 were further increased with duration of treatment, showing no significant difference of subclinical hypothyroidism in sex (17.6%
female vs. 16.6% male), but primary hypothyroidism cases were only observed in female (17.6%) not in male. The mean fT3 level of lithium treated
group was decreased as compared to control group (5.61±1.35 vs. 6.02±1.1, p= 0.051), also showing decreased level of fT4 (17.57±6.35 vs. 19.71±4.56,
p = 0.019). But mean TSH level was found significantly (P<0.001) higher in lithium treated group than that of control (9.67±12.47 vs. 3.41±3.69).
Conclusion:
Our findings indicate that use of lithium therapy is associated with higher degree of primary hypothyroidism and subclinical hypothyroidism
which is being increased with duration of lithium therapy. These results also show slightly higher prevalence of hypothyroidism in female but
statistically not significant.

Author(s):

Rajesh Kumar Gupta

Abstract | PDF

Share this