title: Depressive relapse during lithium treatment associated with increased serum thyroid-stimulating hormone: results from two placebo-controlled bipolar I maintenance studies.
abstract: 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.
  
  
  METHODS
  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 microIU/ml) compared with lithium-treated subjects who did not require intervention for a depressive episode (2.4 microIU/ml).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA. mfrye@mayo.edu
authors.forename: M A
authors.initials: MA
authors.lastname: Frye
authors.forename: L
authors.initials: L
authors.lastname: Yatham
authors.forename: T A
authors.initials: TA
authors.lastname: Ketter
authors.forename: J
authors.initials: J
authors.lastname: Goldberg
authors.forename: T
authors.initials: T
authors.lastname: Suppes
authors.forename: J R
authors.initials: JR
authors.lastname: Calabrese
authors.forename: C L
authors.initials: CL
authors.lastname: Bowden
authors.forename: E
authors.initials: E
authors.lastname: Bourne
authors.forename: R S
authors.initials: RS
authors.lastname: Bahn
authors.forename: B
authors.initials: B
authors.lastname: Adams
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D018692:Antimanic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy*; D004311:Double-Blind Method; D006801:Humans; D000077213:Lamotrigine; D016651:Lithium Carbonate / Q000009:adverse effects* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012189:Retrospective Studies; D013972:Thyrotropin / Q000097:blood*; D014227:Triazines / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D018692:Antimanic Agents; D014227:Triazines; D016651:Lithium Carbonate; D013972:Thyrotropin; D000077213:Lamotrigine