Use of thyroid hormone to diminish the cognitive side effects of psychiatric treatment.
Electroconvulsive therapy (ECT) and lithium are highly effective treatments for mood disorders. Both treatments, however, are associated with cognitive side effects which reduce patient compliance and treatment satisfaction. Both therapies also have a significant effect on hypothalamic-pituitary-thyroid axis (HPT) activity. Preliminary results from a double-blind, placebo-controlled study of adjunctive thyroid hormone (T3) and ECT showed better memory function in patients receiving T3 compared with placebo. This neuroprotective effect of T3 has been confirmed using electroconvulsive shock (ECS) in rats, and shown to be independent of the number of electrical stimulations. Results of studies in patients with bipolar disorder taking lithium have demonstrated that cognitive deficits are significantly related to diminished thyroid status, but not lithium levels. Preliminary evidence also shows that adjunctive thyroid hormone improves cognitive functioning in patients taking lithium. These findings, if replicated and confirmed, indicate a potential role for adjunctive thyroid hormone in reducing the cognitive side effects of these important psychiatric treatments. This, in turn, may lead to improved treatment compliance, diminished overall morbidity, and reduced healthcare utilization.
Tremont
G
G
Department of Psychiatry and Human Behavior, Brown University School of Medicine, Providence, RI, USA.
Stern
R A
RA
D000818:Animals; D003072:Cognition Disorders / Q000139:chemically induced / Q000188:drug therapy* / Q000209:etiology; D004565:Electroconvulsive Therapy / Q000009:adverse effects*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology / Q000503:physiopathology; D007037:Hypothyroidism / Q000503:physiopathology; D008094:Lithium / Q000009:adverse effects*; D051381:Rats; D013961:Thyroid Gland / Q000502:physiology / Q000503:physiopathology; D014284:Triiodothyronine / Q000627:therapeutic use*
D014284:Triiodothyronine; D008094:Lithium