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Manic episode, thyroid gland function and lithium

Published online by Cambridge University Press:  18 September 2015

K. Foeken*
Affiliation:
destijds verbonden aan de afdeling Psychiatrie van het Academisch Ziekenhuis Rotterdam-Dijkzigt (hoofd: Prof. dr. W.J. Schudel) thans Sophia Kinderziekenhuis
B.J.M. van de Wetering
Affiliation:
verbonden aan de afdeling Psychiatrie van het AZR-Dijkzigt
*
Afdeling Kinderpychiatrie, Academisch Ziekenhuis Rotterdam - Dijkzigt/Sophia Kinderziekenhuis Gordelweg 160 3038 CE Rotterdam

Summary

This paper addresses the issue of (recurrent) mania in relation to an increased T4-value, whether or not influenced by lithium. Lithium has an anti-TSH-effect on the thyroid gland by inhibiting the intracellular enzyme adenylate cyclase. This might cause hypothyroidism. Moreover, lithium is also known to have a direct stabilizing effect on (behavioral manifestations) of dopamine receptor supersensitivity.

The hypothesis regarding the relation between thyroid function and affective disturbances is that the altered thyroid function may cause a change in the availability of the central dopamine receptors. Dopamine is known to be able to cause a manic state. TSH and TRH are also involved in this mechanism. It is, therefore, very likely that an increased thyroid function, whether or not caused by discontinuation of lithium-therapy, could induce a (recurrent) mania.

Type
Research Article
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1992

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