[The effect of lithium on thyroid function in patients with bipolar disorder]

Area of Science:

• Endocrinology
• Psychiatry

Context:

• Lithium therapy has been a cornerstone for bipolar disorder (BD) since 1963, effectively managing mood episodes and reducing suicide risk.
• The hypothalamic-pituitary-thyroid (HPT) axis and thyroid gland function are implicated in BD's pathophysiology, clinical course, and treatment response.

Purpose:

• To review the significant impact of long-term lithium treatment on thyroid function.
• To discuss the management strategies for common and rare thyroid-related side effects of lithium therapy.
• To provide recommendations for monitoring thyroid function in patients undergoing long-term lithium treatment.

Summary:

• Lithium treatment, while effective for bipolar disorder, leads to its accumulation in the thyroid gland, disrupting thyroid hormone production and immune processes.
• The most frequent adverse effects include goiter and hypothyroidism, with hyperthyroidism being a rare occurrence.
• Lithium can exacerbate pre-existing thyroid autoimmunity, potentially causing structural changes in the gland.

Impact:

• This review offers crucial insights into managing lithium-induced thyroid dysfunction, aiding clinicians in optimizing patient care.
• Establishing clear monitoring guidelines for thyroid function is essential for patients on long-term lithium therapy to mitigate risks.
• Understanding these thyroidal effects improves the comprehensive management of bipolar disorder patients receiving lithium.