A Historical Cohort Study Examined the Relationship between Thyroid Issues and Long-Term Lithium Therapy in Bipolar Disorder

Mark Treeby^*
*Correspondence: Mark Treeby, Department of Psychiatry Psychology, Mayo Clinic, Rochester, USA, Email:

Introduction

The cornerstone therapy for bipolar disorder has been lithium. Despite reports of connections between long-term lithium medication and the development of a thyroid disease in the literature, aspects such as the timing of thyroid abnormalities' emergence and their influence on clinical outcomes during the course of the illness have not been extensively defined. In this study, we compared the clinical characteristics of adult patients who were taking medication and had thyroid issues with those who weren't. Our goal was to compare individuals with and without thyroid abnormalities in terms of how well they responded to lithium and the prevalence of thyroid disorders in those patients. The median time before the onset of a thyroid problem was calculated using the Cox proportional model. Particularly in bipolar illness, thyroid function is crucial for mood stability. There have been reports of both increasing and decreasing rates of aberrant thyroid function in the American population. Similar to mood problems, hypothyroidism affects more women than men.

Description

The use of lithium treatment is one of the likely reasons of thyroid dysfunction in people. The thyroid peroxidase antibodies, female sex, advanced age, and a favourable family history of hypothyroidism have all been found as risk factors for Li-induced hypothyroidism. Hypothyroidism is frequently caused by thyroid autoimmunity, which may or may not be related to Li therapy. Rapid cycling in can be caused by hypothyroidism, albeit this has not always been demonstrated. may result in hyperthyroidism as well. uncommon cases of Graves' illness with hyperthyroidism Although lithium is a proven mood stabilizer, it is still underused, especially in the Thyroid and renal dysfunctions linked to possible lithium usage, necessitating continuous monitoring of renal and thyroid indices, have been cited as some of the causes for this underutilization. It is still unclear, nevertheless, whether Li-induced hypothyroidism calls for Li to be stopped. Li has been shown to have a number of biological effects on the thyroid gland in pre-clinical studies, some of which include an increase in the amount of iodine within the thyroid gland, a decrease in the activity of the thyroid gland for producing thyroxine and triiodothyronine, a blockage of the release of thyroid hormones from the gland, and a change in the structure of the immunoglobulin [1-3].

We included adult patients with BD who were enrolled in the Mayo Clinic Bipolar Biobank at the Mayo Clinic in Rochester, Minnesota, and who were taking lithium for at least a year. All of the patients were diagnosed with type II or schizoaffective bipolar disorder according to criteria. Patients who weren't on our list of The Linder Center of of Cincinnati, the University of Minnesota, and the Mayo Clinic formed the Bipolar Biobank to collaborate on research on pharmacogenomics therapy response and illness risk. The Mayo Clinic Institutional Review Board authorised this study. The information on demographics, health conditions, the length of Li therapy, and other clinical parameters [4].

Digital health records The Mayo Data Explorer, accessible at the Mayo Clinic, was used to extract laboratory data. By summing the length of the various Li trials that were previously published, the duration of Li therapy was computed through chart review. We utilised the Modified Cumulative Illness Rating Scale to evaluate the burden of medical disease. The severity index is the mean of the scores of the first categories, excluding psychiatric comorbidity, to study the burden of comorbidity; individual category mean score was evaluated to study the specific comorbidity. The severity index identifies items involving various systems with a score range The Alda-A scale was used to evaluate the treatment response to The Aldi-A scale, which is graded on its ability to measure clinical improvement in sickness intensity, duration, and frequency According to and, a therapeutic response was classified as an excellent, moderate, or poor response. scores between ratters reaching, internal consistency was previously evaluated using Kappa statistics infraclass correlation As the A sub scale has demonstrated equivalent intracranial correlate to the overall score, we chose to utilise it. The -A score, however, was not adjusted for any confounding variables [5].

Conclusion

Studies have specifically highlighted that 33% of individuals with mixed affective states and in cases of pure manic episodes showed TSH abnormalities importantly, it has been noted that Li therapy raises the occurrence of thyroid diseases. of participants in our research experienced thyroid problems within a year of starting lithium treatment. This is less than what some prior research had reported. The inclusion of patients with BD and schizoaffective disorders during the depressive phase and a focus on patients who stopped taking Li may be a plausible explanation for these findings, according to a Swedish retrospective cohort study that found a mean delay from lithium to initiation of with a median of 10 months. In this investigation, we found that thyroid problem diagnoses were diagnosed.

Acknowledgement

None.

Conflict of Interest

There are no conflicts of interest by author.

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