NDLI: Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study

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Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study

Content Provider	MDPI
Author	Louise, Öhlund Lieber, Ingrid Ott, Michael Lundqvist, Robert Eliasson, Mats Sandlund, Mikael Werneke, Ursula
Copyright Year	2021
Description	The prescription of thyroid hormone replacement therapy (THRT) has increased in the general population; the thyroid stimulating hormone (TSH) threshold to initiate THRT has decreased. It remains unclear whether a similar trend has occurred in patients with bipolar disorder (BD). In this work we explore patterns and trends of prescribing THRT in patients with BD or schizoaffective disorder (SZD) with an observational study and time-trend analysis in the framework of the LiSIE (Lithium—Study into Effects and Side Effects) retrospective cohort study. In most patients, THRT was initiated for subclinical hypothyroidism. The median TSH at which THRT was started was 6.0 (IQR 4.0) mIU/L and the median free serum thyroxine (fT4) at which THRT was started was 11.8 (IQR 3.9) pmol/L. The median TSH concentration at the start of THRT decreased annually with 0.10 mIU/L (p = 0.047) and was higher in patients treated with lithium than in patients treated with other mood stabilisers (p = 0.02). In conclusion, THRT was typically initiated in the context of mild or absent alterations of thyroid function tests with a decreasing TSH threshold. As THRT is rarely reversed once initiated, clinicians need to weigh up potential benefits and risks when prescribing THRT for subclinical hypothyroidism in patients with BD or SZD.
Starting Page	5062
e-ISSN	20770383
DOI	10.3390/jcm10215062
Journal	Journal of clinical medicine
Issue Number	21
Volume Number	10
Language	English
Publisher	MDPI
Publisher Date	2021-10-29
Access Restriction	Open
Subject Keyword	Journal of clinical medicine Journal of Clinical Medicine Psychiatry and Mental Health Bipolar Disorder Schizoaffective Disorder Lithium Mood Stabilizer Hypothyroidism Thyroid Dysfunction Tsh
Content Type	Text
Resource Type	Article

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