Effects of lithium on the endocrine system: a review

Lithium has been established as a useful drug for the treatment of mood and behavior disorders. In addition to its therapeutic role in psychiatric disease it is important to recognize that it has diverse effects on endocrine function. These include the development of hypothyroidism and goiter in up to 10% of patients. Hyperthyroidism is a rare but reported side effect. Other abnormalities include hypercalcemia, diabetes insipidus, and altered carbohydrate metabolism. Depending on the clinical situation it is usually not necessary to discontinue lithium treatment, but appropriate intervention to correct the resulting endocrine abnormality may be indicated. This review emphasizes that psychiatrists and clinicians caring for patients given lithium need to be aware of the possible endocrine effects of this drug.