open access

Vol 71, No 4 (2020)
Original paper
Published online: 2020-06-01
Submitted: 2020-02-06
Accepted: 2020-05-19
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Changes in serum thyroid hormone levels in psychiatric patients treated with second-generation antipsychotics

Jia-Xuan Zhang, Xun Li
DOI: 10.5603/EP.a2020.0036
·
Pubmed: 32901909
·
Endokrynologia Polska 2020;71(4):292-298.

open access

Vol 71, No 4 (2020)
Original Paper
Published online: 2020-06-01
Submitted: 2020-02-06
Accepted: 2020-05-19

Abstract

Introduction: The objective of the study was to evaluate changes in serum thyroid hormone levels in psychiatric patients after second-generation antipsychotic (SGA) treatment, and to determine differences between monotherapy and  polytherapy with SGAs, as well as differences between patients with and without a history of antipsychotics.

Material and methods: A total of 71 patients with baseline thyroid hormone levels within the normal reference ranges were included in this retrospectively study.

Results: After SGAs treatment, the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), and total thyroxine (TT4) significantly decreased, and serum thyroid-stimulating hormone (TSH) levels significantly increased (changes from baseline: FT3: –0.31 pmol/L, p < 0.001; FT4: –2.71 pmol/L, p < 0.001; TT3: –0.05 nmol/L, p = 0.024, TT4: –12.36 nmol/L, p < 0.001; TSH: 0.46 mIU/L, p < 0.001). One (1.4%) patient had TSH levels higher than 7 mIU/L. Changes in serum levels of TSH and TT3 between patients with or without a history of antipsychotic drugs were significantly different (changes from baseline: TSH: p < 0.001 vs. p = 0.089; TT3: p = 0.013
vs. p = 0.553). Changes in serum TSH levels had a moderate positive correlation with the average daily dose of SGAs (p = 0.007, r = 0.318).

Conclusions: After SGA treatment, patients seemed to have a trend of hypothyroidism, but the incidence was low. The preliminary results of this study did not show the necessity of regular monitoring of serum thyroid hormone levels in patients with baseline thyroid hormone levels within the normal reference ranges.

Abstract

Introduction: The objective of the study was to evaluate changes in serum thyroid hormone levels in psychiatric patients after second-generation antipsychotic (SGA) treatment, and to determine differences between monotherapy and  polytherapy with SGAs, as well as differences between patients with and without a history of antipsychotics.

Material and methods: A total of 71 patients with baseline thyroid hormone levels within the normal reference ranges were included in this retrospectively study.

Results: After SGAs treatment, the serum levels of free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), and total thyroxine (TT4) significantly decreased, and serum thyroid-stimulating hormone (TSH) levels significantly increased (changes from baseline: FT3: –0.31 pmol/L, p < 0.001; FT4: –2.71 pmol/L, p < 0.001; TT3: –0.05 nmol/L, p = 0.024, TT4: –12.36 nmol/L, p < 0.001; TSH: 0.46 mIU/L, p < 0.001). One (1.4%) patient had TSH levels higher than 7 mIU/L. Changes in serum levels of TSH and TT3 between patients with or without a history of antipsychotic drugs were significantly different (changes from baseline: TSH: p < 0.001 vs. p = 0.089; TT3: p = 0.013
vs. p = 0.553). Changes in serum TSH levels had a moderate positive correlation with the average daily dose of SGAs (p = 0.007, r = 0.318).

Conclusions: After SGA treatment, patients seemed to have a trend of hypothyroidism, but the incidence was low. The preliminary results of this study did not show the necessity of regular monitoring of serum thyroid hormone levels in patients with baseline thyroid hormone levels within the normal reference ranges.

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Keywords

antipsychotics; psychiatric; thyroid; thyroxine; triiodothyronine; thyroid-stimulating hormone; risperidone; olanzapine; clozapine

About this article
Title

Changes in serum thyroid hormone levels in psychiatric patients treated with second-generation antipsychotics

Journal

Endokrynologia Polska

Issue

Vol 71, No 4 (2020)

Article type

Original paper

Pages

292-298

Published online

2020-06-01

DOI

10.5603/EP.a2020.0036

Pubmed

32901909

Bibliographic record

Endokrynologia Polska 2020;71(4):292-298.

Keywords

antipsychotics
psychiatric
thyroid
thyroxine
triiodothyronine
thyroid-stimulating hormone
risperidone
olanzapine
clozapine

Authors

Jia-Xuan Zhang
Xun Li

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