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J Psychiatry Neurosci. 1999 May; 24(3): 227–233.
PMCID: PMC1189013

Effect of lithium maintenance therapy on thyroid and parathyroid function.

Abstract

OBJECTIVES: To assess changes induced by lithium maintenance therapy on the incidence of thyroid, parathyroid and ion alterations. These were evaluated with respect to the duration of lithium therapy, age, sex, and family history (whether or not the patient had a first-degree relative with thyroid disease). DESIGN: Prospective study. SETTING: Affective Disorders Clinic at St. Mary's Hospital, Montreal. PATIENTS: One hundred and one patients (28 men and 73 women) with bipolar disorder receiving lithium maintenance therapy ranging from 1 year's to 32 years' duration. The control group consisted of 82 patients with no psychiatric or endocrinological diagnoses from the hospital's out-patient clinics. OUTCOME MEASURES: Laboratory analyses of calcium, magnesium and thyroid-stimulating hormone levels performed before beginning lithium therapy and at biannual follow-up. RESULTS: Hypothyroidism developed in 40 patients, excluding 8 patients who were hypothyroid at baseline. All patients having first-degree relatives affected by thyroid illness had accelerated onset of hypothyroidism (3.7 years after onset of lithium therapy) compared with patients without a family history (8.6 years after onset of lithium therapy). Women over 60 years of age were more often affected by hypothyroidism than women under 60 years of age (34.6% versus 31.9%). Magnesium levels in patients on lithium treatment were unchanged from baseline levels. After lithium treatment, calcium levels were higher than either baseline levels or control levels. Thus, lithium treatment counteracted the decrease in plasma calcium levels associated with aging. CONCLUSIONS: Familial thyroid illness is a risk factor for hypothyroidism and hypercalcemia during lithium therapy.

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Selected References

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  • Piziak VK, Sellman JE, Othmer E. Lithium and hypothyroidism. J Clin Psychiatry. 1978 Sep;39(9):709–711. [PubMed]
  • Franks RD, Dubovsky SL, Lifshitz M, Coen P, Subryan V, Walker SH. Long-term lithium carbonate therapy causes hyperparathyroidism. Arch Gen Psychiatry. 1982 Sep;39(9):1074–1077. [PubMed]
  • Stancer HC, Forbath N. Hyperparathyroidism, hypothyroidism, and impaired renal function after 10 to 20 years of lithium treatment. Arch Intern Med. 1989 May;149(5):1042–1045. [PubMed]
  • Dousa TP. Interaction of lithium with vasopressin-sensitive cyclic AMP system of human renal medulla. Endocrinology. 1974 Nov;95(5):1359–1366. [PubMed]
  • Manji HK. G proteins: implications for psychiatry. Am J Psychiatry. 1992 Jun;149(6):746–760. [PubMed]
  • Baraban JM, Worley PF, Snyder SH. Second messenger systems and psychoactive drug action: focus on the phosphoinositide system and lithium. Am J Psychiatry. 1989 Oct;146(10):1251–1260. [PubMed]
  • Price LH, Charney DS, Delgado PL, Heninger GR. Lithium treatment and serotoninergic function. Neuroendocrine and behavioral responses to intravenous tryptophan in affective disorder. Arch Gen Psychiatry. 1989 Jan;46(1):13–19. [PubMed]
  • Kusalic M, Engelsmann F. Effect of lithium maintenance treatment on hypothalamic pituitary gonadal axis in bipolar men. J Psychiatry Neurosci. 1996 May;21(3):181–186. [PMC free article] [PubMed]
  • Burrow GN, Burke WR, Himmelhoch JM, Spencer RP, Hershman JM. Effect of lithium on thyroid function. J Clin Endocrinol Metab. 1971 May;32(5):647–652. [PubMed]
  • Lazarus JH, John R, Bennie EH, Chalmers RJ, Crockett G. Lithium therapy and thyroid function: a long-term study. Psychol Med. 1981 Feb;11(1):85–92. [PubMed]
  • Evered DC, Ormston BJ, Smith PA, Hall R, Bird T. Grades of hypothyroidism. Br Med J. 1973 Mar 17;1(5854):657–662. [PMC free article] [PubMed]
  • Bauer MS, Whybrow PC, Winokur A. Rapid cycling bipolar affective disorder. I. Association with grade I hypothyroidism. Arch Gen Psychiatry. 1990 May;47(5):427–432. [PubMed]
  • Kusalic M. Grade II and grade III hypothyroidism in rapid-cycling bipolar patients. Neuropsychobiology. 1992;25(4):177–181. [PubMed]
  • Gewirtz GR, Malaspina D, Hatterer JA, Feureisen S, Klein D, Gorman JM. Occult thyroid dysfunction in patients with refractory depression. Am J Psychiatry. 1988 Aug;145(8):1012–1014. [PubMed]
  • Spaulding SW, Burrow GN, Ramey JN, Donabedian RK. Effect of increased iodide intake on thyroid function in subjects on chronic lithium therapy. Acta Endocrinol (Copenh) 1977 Feb;84(2):290–296. [PubMed]
  • Feinberg M, Steiner M, Carroll BJ. Effects of long-term lithium treatment on serum calcium, magnesium, and calcitonin [proceedings]. Psychopharmacol Bull. 1979 Apr;15(2):81–84. [PubMed]
  • Waller DG, Albano JD, Millar JG, Polak A. Cyclic AMP responses to parathyroid hormone and glucagon during lithium treatment. Clin Sci (Lond) 1984 May;66(5):557–559. [PubMed]
  • Christiansen C, Baastrup PC, Transbøl I. Development of 'primary' hyperparathyroidism during lithium therapy: longitudinal study. Neuropsychobiology. 1980;6(5):280–283. [PubMed]
  • Haden ST, Stoll AL, McCormick S, Scott J, Fuleihan G el-H Alterations in parathyroid dynamics in lithium-treated subjects. J Clin Endocrinol Metab. 1997 Sep;82(9):2844–2848. [PubMed]
  • Shen FH, Sherrard DJ. Lithium-induced hyperparathyroidism: an alteration of the "set-point". Ann Intern Med. 1982 Jan;96(1):63–65. [PubMed]
  • Birch NJ, Greenfield AA, Hullin RP. Lithium therapy and alkaline earth metal metabolism: a biochemical screening study. Psychol Med. 1977 Nov;7(4):613–618. [PubMed]
  • Joffe RT, Kutcher S, MacDonald C. Thyroid function and bipolar affective disorder. Psychiatry Res. 1988 Aug;25(2):117–121. [PubMed]
  • Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, Evans JG, Young E, Bird T, Smith PA. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol (Oxf) 1977 Dec;7(6):481–493. [PubMed]
  • Bilous RW, Tunbridge WM. The epidemiology of hypothyroidism--an update. Baillieres Clin Endocrinol Metab. 1988 Aug;2(3):531–540. [PubMed]
  • Sawin CT, Castelli WP, Hershman JM, McNamara P, Bacharach P. The aging thyroid. Thyroid deficiency in the Framingham Study. Arch Intern Med. 1985 Aug;145(8):1386–1388. [PubMed]
  • Krahn DD. Affective disorder associated with subclinical hypothyroidism. Psychosomatics. 1987 Aug;28(8):440–441. [PubMed]
  • Tapp A. Affective cycling in thyroid disease. J Clin Psychiatry. 1988 May;49(5):199–200. [PubMed]

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