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

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 expl...

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Autores principales:	Ingrid Lieber, Michael Ott, Louise Öhlund, Robert Lundqvist, Mats Eliasson, Mikael Sandlund, Ursula Werneke
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	bipolar disorder schizoaffective disorder lithium mood stabilizer hypothyroidism thyroid dysfunction Medicine R
Acceso en línea:	https://doaj.org/article/f8b6f84b29e9440a86f4905326d7e984
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spelling	oai:doaj.org-article:f8b6f84b29e9440a86f4905326d7e9842021-11-11T17:41:13ZPatterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study10.3390/jcm102150622077-0383https://doaj.org/article/f8b6f84b29e9440a86f4905326d7e9842021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5062https://doaj.org/toc/2077-0383The 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 (<i>p</i> = 0.047) and was higher in patients treated with lithium than in patients treated with other mood stabilisers (<i>p</i> = 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.Ingrid LieberMichael OttLouise ÖhlundRobert LundqvistMats EliassonMikael SandlundUrsula WernekeMDPI AGarticlebipolar disorderschizoaffective disorderlithiummood stabilizerhypothyroidismthyroid dysfunctionMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5062, p 5062 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	bipolar disorder schizoaffective disorder lithium mood stabilizer hypothyroidism thyroid dysfunction Medicine R
spellingShingle	bipolar disorder schizoaffective disorder lithium mood stabilizer hypothyroidism thyroid dysfunction Medicine R Ingrid Lieber Michael Ott Louise Öhlund Robert Lundqvist Mats Eliasson Mikael Sandlund Ursula Werneke Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study
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 (<i>p</i> = 0.047) and was higher in patients treated with lithium than in patients treated with other mood stabilisers (<i>p</i> = 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.
format	article
author	Ingrid Lieber Michael Ott Louise Öhlund Robert Lundqvist Mats Eliasson Mikael Sandlund Ursula Werneke
author_facet	Ingrid Lieber Michael Ott Louise Öhlund Robert Lundqvist Mats Eliasson Mikael Sandlund Ursula Werneke
author_sort	Ingrid Lieber
title	Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study
title_short	Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study
title_full	Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study
title_fullStr	Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study
title_full_unstemmed	Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study
title_sort	patterns of thyroid hormone prescription in patients with bipolar or schizoaffective disorder: findings from the lisie retrospective cohort study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/f8b6f84b29e9440a86f4905326d7e984
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Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study

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