Thyroid axis function after in-patient treatment of acute psychosis with antipsychotics: a naturalistic study

BMC Psychiatry

Arthur J Prange²  Vesta Steibliene¹  Robertas Bunevicius³ 

[1]Clinic of Psychiatry, Lithuanian University of Health Sciences, Mickeviciaus str. 9, Kaunas LT-44307, Lithuania

[2]Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

[3]Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno str. 4, Palanga LT-00135, Lithuania

关键词: Antipsychotics;    Treatment;    Thyroid stimulating hormone;    Triiodothyronine;    Thyroxine;    Psychosis;   

Others  :  1123314
DOI  :  10.1186/s12888-014-0279-7

 received in 2014-04-10, accepted in 2014-09-26,  发布年份 2014

【 摘 要 】

Background

Endocrine function in psychiatric patients may be affected by mental disorder itself as well as by antipsychotic medications.

The aim of this naturalistic observational study was to determine if treatment of acute psychotic episode with antipsychotic medication affects thyroid axis hormone concentrations and if such changes are associated with symptomatic improvement.

Methods

Eighty six adult acute psychotic patients, consecutively admitted to a mental hospital, were recruited for the study. All patients were physically healthy and without thyroid disease. During the hospitalization period all study patients received treatment with antipsychotic medication according to clinical need. Severity of the psychotic episode was evaluated using the Brief Psychiatric Rating Scale (BPRS) and venous blood samples were drawn for analysis of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) concentrations on the day of admission and on the day of discharge from the hospital.

Results

Antipsychotic drug treatment was associated with decrease of mean FT3 (p < 0.001) and FT4 (p = 0.002) concentrations; and with increase of mean TSH (p = 0.016) concentrations. Changes in thyroid hormone concentrations were mostly predicted by baseline hormone concentrations. Individual changes were not limited to decrease in high hormone concentrations; in patients who had low FT3 or FT4 concentrations, treatment resulted in increase in concentrations. Such an increase was established in one-quarter of patients for FT3 concentrations and in one-third of patients for FT4 concentrations. Fall in FT4 concentrations negatively correlated with the improvement in the BPRS score (r = −0.235, p = 0.023).

Conclusions

The study indicates that antipsychotic treatment resulted in a decrease in mean FT3 concentrations and in an increase in mean TSH concentrations after recovery from acute psychosis. Symptomatic improvement was less evident in patients who experienced a decrease in FT4 concentrations.

Trial registration

EudraCT No.2007-001541-18 webcite

【 授权许可】

   
2014 Bunevicius et al.; licensee BioMed Central Ltd.

【 图 表 】

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