Ultrasonographically Measured Change in Thyroid Status in Lithium Treated Adult Patients with Mood Disorder.
BACKGROUND
Lithium, which is frequently used in the treatment of mood disorder, can lead to various types of thyroid dysfunctions. Although clinical examination and biochemical assessment are fundamental to any thyroid work-up of lithium-treated patients, assessment findings vary widely depending on the investigator. Ultrasonographic measurement of thyroid volume has, therefore, been performed in lithium treatment populations and found to be a sensitive tool.


OBJECTIVE
We aimed to determine and compare thyroid gland volume using Ultrasonography and laboratory parameters, (thyroid-stimulating hormone [TSH], T3, and T4) in long-term lithium and other mood stabilizers treated patients with mood disorder.


METHODS
In this cross-sectional study, we performed ultrasonography examinations and thyroid function test of 30 patients on lithium treatment and 30 patients on other mood stabilizers.


RESULTS
The ultrasonographically measured thyroid volume was significantly increased in patients receiving lithium therapy as compared to the patients receiving other mood stabilizers. The total triiodothyronine (T3) was significantly increased with trends toward increased total thyroxine (T4) and decreased TSH in patients receiving lithium therapy as compared to the patients receiving other mood stabilizers.


CONCLUSIONS
These results highlight the need of including ultrasonographic measurement of thyroid volume as a part of standard thyroid work-up before initiating lithium prophylaxis and during follow-up. Additional studies on the incidence and mechanism of lithium associated hyperthyroidism are needed.
Academic Section, LGB Regional Institute of Mental Health, Department of Psychiatry, Tezpur, Assam, India.
Sekh Afrar
SA
Alam
Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Vinod Kumar
VK
Sinha
Central Institute of Psychiatry, Ranchi, Jharkhand, India.
Haque
H
Nizamie
Lithium; mood disorder mood stabilizer; thyroid function test; thyroid ultrasonography