Correlation of serum lithium levels and thyroid function tests in subjects of bipolar affective disorder: a prospective hospital-based study

M. S. Manjuprasad, Padmaja Udaykumar, D. S. Maitreyee, Shreya Hegde

Abstract


Background: Lithium is used in the prophylaxis of long-term therapy of bipolar affective disorder (BPAD) as a mood-stabilizing agent. Thyroid function abnormality is very commonly seen adverse effect, more common in females than males. This study aimed to correlate lithium levels and thyroid function abnormalities associated with it.

Methods: Evaluation of medical records of 150 patients in Father Muller Medical College with BPAD, who were treated for 6 months with lithium, carried out from February, 12 2014 to July, 20 2014. Serum lithium levels done by ion selective electrode method in ilyte analyzer and thyroid function test (TFT) by electrochemiluminescence. Data are analyzed by Karl Pearson correlation coefficient.

Results: Correlation of lithium levels and TFT in BPAD patients according to Karl Pearson correlation coefficient was negative with significant p<0.002. Among 150 enrolled candidates, 52 (34.67%) were females and 98 (65.4%) were males, 4% (6) patients (3 males and 3 females) had thyroid stimulating hormone (TSH) value <0.27 with an average lithium value of 1.35 mEq/L, 6% (9) patients (5 males and 4 females) had TSH value >4.2 with an average lithium levels of 0.44 mEq/L and 90% of the patients with an average lithium levels 0.66 mEq/L had no thyroid function abnormalities.

Conclusions: As already known, Lithium is a drug of narrow therapeutic index and females are more prone for thyroid function abnormalities. Appropriate monitoring of serum lithium levels will aid in necessary dose adjustment and ensure proper utilization of drug.


Keywords


Bipolar affective disorder, Hyperthyroidism, Hypothyroidism, Lithium

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