Correlation of Serum Lithium Levels and Thyroid Function Tests in Subjects of Bipolar Affective Disorder Ã¢ÂÂ A Hospital Based Prospective Study

Manjuprasad Ms Shreya H

doi:10.4172/2167-0501.1000176

Abstract

Background: Lithium is used in prophylaxis of long term therapy of BPAD as a mood stabilizing agent. Thyroid function abnormality is very commonly seen adverse effect, more common in females than males. This study aims to correlate lithium levels and thyroid function abnormalities associated with it. Methods and materials: Evaluation of medical records of 150 patients in Fr Muller Medical College with BPAD who were treated for 6 months with lithium, Carried out from 12-02-2014 to 20-07-2014. S. lithium levels done by Ion elective electrode method in ilyte analyzer and 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 co-efficient was negative with significant p value of 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. Conclusion: 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.

Highlights

Bipolar affective disorder (BPAD) known as manic depressive illness is a brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day to day tasks
Lithium exerts its effects through multiple mechanisms which include inositol depletion as a consequence of which there is increased signaling within the cells [5], induction of autophagy because of which there is degradation of cellular proteins and organelles accounting for quality control function [6], Inhibition of NMDA receptor mediated signaling [1,8,10], Inhibition of glycogen synthase kinase 3 (GSK3), which is a proapoptotic and regulator of inflammation and increases the β catenins which is responsible for antiapoptosis of growth hormones [7]
Patients clinically diagnosed with bipolar affective disorder on lithium between 18 yrs to 65 yrs of either sex were included in the study

Summary

Introduction

Bipolar affective disorder (BPAD) known as manic depressive illness is a brain disorder that causes unusual shifts in mood, energy, activity levels and the ability to carry out day to day tasks. People with bipolar disorder are at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses [1]. Lithium, used in the prophylaxis of Bipolar affective disorder reduces the severity and frequency of mania and been shown to reduce suicidal risk and short term mortality [3]. It was found that thyroid function abnormalities were more common in females than males [4]. Thyroid function abnormality is very commonly seen adverse effect, more common in females than males. This study aims to correlate lithium levels and thyroid function abnormalities associated with it

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Results

Conclusion