Association between lower serum free T-4 and greater mood instability and depression in lithium-maintained bipolar patients

Citation
Ma. Frye et al., Association between lower serum free T-4 and greater mood instability and depression in lithium-maintained bipolar patients, AM J PSYCHI, 156(12), 1999, pp. 1909-1914
Citations number
46
Categorie Soggetti
Psychiatry,"Clinical Psycology & Psychiatry","Neurosciences & Behavoir
Journal title
AMERICAN JOURNAL OF PSYCHIATRY
ISSN journal
0002953X → ACNP
Volume
156
Issue
12
Year of publication
1999
Pages
1909 - 1914
Database
ISI
SICI code
0002-953X(199912)156:12<1909:ABLSFT>2.0.ZU;2-S
Abstract
Objective: This investigation evaluated the relationship between changes in thyroid indices and mood stability during lithium and carbamazepine prophy laxis for bipolar disorder. Method: In the first 2 years, 30 patients with bipolar mood disorder were randomly assigned to 1 year of lithium and then 1 year of carbamazepine, or vice versa; in the third year, they received li thium plus carbamazepine. By stepwise regression analysis, the degree and t iming of lithium- and carbamazepine-induced thyroid changes and their subse quent relationship to long-term mood stability were evaluated. Results: Dur ing the lithium phase, there was a significant inverse relationship between morbidity and mean serum level of free T-4, i.e., a lower mean serum level of free T-4 was associated with more affective episodes and greater severi ty of depression as shown by the Beck Depression Inventory. During the carb amazepine phase, there was an inverse relationship between mean level of to tal T-4 and global severity rating. During the combination phase, no relati onships between thyroid indices and clinical outcome were significant. Conc lusions: In the lithium phase, a low level of free T-4 was associated with more affective episodes and greater severity of depression. Whether this mo od instability is causally related to low free T-4 levels and whether it ca n be attenuated with T-4 replacement remain to be studied in a controlled s etting.