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Depressive relapse during lithium treatment associated with increased serum thyroid‐stimulating hormone: results from two placebo‐controlled bipolar I maintenance studies
Author(s) -
Frye M. A.,
Yatham L.,
Ketter T. A.,
Goldberg J.,
Suppes T.,
Calabrese J. R.,
Bowden C. L.,
Bourne E.,
Bahn R. S.,
Adams B.
Publication year - 2009
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/j.1600-0447.2008.01343.x
Subject(s) - bipolar disorder , lithium (medication) , mood stabilizer , lamotrigine , placebo , medicine , maintenance therapy , mood , thyroid function , psychology , post hoc analysis , thyroid stimulating hormone , depression (economics) , endocrinology , thyroid , psychiatry , chemotherapy , epilepsy , alternative medicine , pathology , economics , macroeconomics
Objective: To assess the relationship between depressive relapse and change in thyroid function in an exploratory post hoc analysis from a controlled maintenance evaluation of bipolar I disorder. Method: Mean thyroid‐stimulating hormone (TSH) and outcome data were pooled from two 18‐month, double‐blind, placebo‐controlled, maintenance studies of lamotrigine and lithium monotherapy. A post hoc analysis of 109 subjects ( n = 55 lamotrigine, n = 32 lithium, n = 22 placebo) with serum TSH values at screening and either week 52 (±14 days) or study drop‐out was conducted. Results: Lithium‐treated subjects who required an intervention for a depressive episode had a significantly higher adjusted mean TSH level (4.4 μIU/ml) compared with lithium‐treated subjects who did not require intervention for a depressive episode (2.4 μIU/ml). Conclusion: Lithium‐related changes in thyroid function are clinically relevant and should be carefully monitored in the maintenance phase of bipolar disorder to maximize mood stability and minimize the risk of subsyndromal or syndromal depressive relapse.