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Thyroid functions in patients with bipolar disorder and the impact of quetiapine monotherapy: a retrospective, naturalistic study

Authors Li C, Lai J, Huang T, Han Y, Du Y, Xu Y, Hu S

Received 1 December 2018

Accepted for publication 2 July 2019

Published 9 August 2019 Volume 2019:15 Pages 2285—2290


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Jun Chen

Chao Li,1–3,* Jianbo Lai,1,4,5,* Tingting Huang,2 Yuqing Han,2 Yanli Du,2 Yi Xu,1,4,5 Shaohua Hu1,4,5

1Department of Psychiatry, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, People’s Republic of China; 2Department of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou 310003, People’s Republic of China; 3Department of Psychiatry, Ningbo Psychiatric Hospital of Zhejiang Province, Ningbo 315000, People’s Republic of China; 4The Key Laboratory of Mental Disorder’s Management in Zhejiang Province, Hangzhou 310003, People’s Republic of China; 5Brain Research Institute of Zhejiang University, Hangzhou 310003, People’s Republic of China

*These authors contributed equally to this work

Objective: Previous studies have demonstrated a potentially close relationship between mood disorders and thyroid abnormalities. The aims of this study are to investigate: 1) whether significant differences of thyroid profiles exist between manic and depressive episodes in patients with bipolar disorder (BD); 2) the impact of quetiapine monotherapy on thyroid functions in depressed BD patients.
Methods: In this retrospective naturalistic study, we reviewed patients’ information based on an electronic medical system from January 2015 to April 2019. Patients with a discharge diagnosis of BD, a current depressive or manic episode, were screened. All depressed BD patients were treated with quetiapine monotherapy for at least one month. For all patients enrolled, the demographic, clinical data and thyroid functions were recorded. The differences between thyroid profiles including total thyroxine (TT4), total triiodothyronine (TT3), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) between patients with different episodes were analyzed. In addition, the change of thyroid functions before and after one-month or three-month quetiapine treatment in depressed BD patients was also analyzed.
Results: Totally, 28 patients with a manic episode and 58 patients with a depressive episode were enrolled. No significant differences in thyroid profiles were found in patients with different mood episodes. After one-month quetiapine treatment, serum levels of TT4, FT4 and FT3 were significantly reduced (P<0.05), TSH was increased (P=0.015), while TT3 was not significantly changed (P=0.425). After three-month quetiapine treatment, serum levels of TT4, TT3, FT4 and FT3 were significantly reduced (P<0.05), except TSH (P=0.990).
Conclusion: These findings indicate that thyroid functions were not significantly fluctuated between depressive and manic episodes in BD patients. Nonetheless, quetiapine treatment may disturb the thyroid system and needs close monitoring.

Keywords: thyroid function, bipolar disorder, quetiapine, mania

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