6-YEAR FOLLOW-UP OF THYROID-FUNCTION DURING LITHIUM TREATMENT

A cohort of patients at various stages of lithium treatment was follow ed up for 6 years in order to evaluate the course of thyroid abnormali ties. Ultrasonography confirmed that lithium can increase thyroid size , especially in cigarette smokers, and that it can affect the texture of the gland. However, the incidence of clinical hypothyroidism or spe cific thyroid autoimmunity does not exceed that found in the general p opulation. Repeated determinations of thyrotrophin (TSH) concentration s can prevent clinically relevant consequences. Addition of carbamazep ine to lithium can counteract lithium-induced subclinical hypothyroidi sm, possibly improving prophylactic efficacy in recurrent affective di sorders.