Central thyroid stimulation in severely ill depressed, manic and schizophrenic patients

Abstract

A blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) has frequently been reported in endogenous depression and in other psychiatric diseases (Loosen and Prange 1982). Several studies have also reported an increased TSH response to TRH associated with low-normal thyroid hormone levels, particularly in depressed women (Targum et al. 1982; Calloway et al. 1984). Other authors have found abnormalities in thyroid hormone levels in different psychiatric disorders, with conflicting results on the possibilities of a relationship to blunted TRH test results (Prange et al. 1979; Kirkegaard and Faber 1981, Calloway et al. 1984). We evaluated the longitudinal pattern of TRH test results and thyroid hormone values in 35 patients with major depression and 15 control patients with schizophrenia and mania. Surprisingly, we found that four patients showed a simultaneous increase in the TSH response to TRH and all thyroid hormones during severe depressive, manic or psychotic crisis. Results with these four patients are presented.