ArticleBipolar disorders2016
Hypothyroidism risk compared among nine common bipolar disorder therapies in a large US cohort.
Article in Bipolar disorders, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 39 citations in OpenAlex.
- Metabolic Effects of Aripiprazole and Olanzapine Multiple-Dose Treatment in a Randomised Crossover Clinical Trial in Healthy Volunteers: Association with Pharmacogenetics.Advances in therapy · 2021Trial
- Lithium-induced neuroprotection in bipolar disorder: Translational insights into cytoskeletal and proteomic mechanisms.IBRO neuroscience reports · 2025Review
- Independent and medication related effects of bipolar disorder on thyroid and reproductive hormones in women.Scientific reports · 2025Article
- Lithium for Bipolar Disorder and Risk of Thyroid Dysfunction and Chronic Kidney Disease.JAMA network open · 2025Article
- Why is lithium [not] the drug of choice for bipolar disorder? a controversy between science and clinical practice.International journal of bipolar disorders · 2024Review
- Subclinical thyroid dysfunction and major depressive disorder.Hormones (Athens, Greece) · 2021Review
- Patterns of Thyroid Hormone Prescription in Patients with Bipolar or Schizoaffective Disorder: Findings from the LiSIE Retrospective Cohort Study.Journal of clinical medicine · 2021Article
- Medical Comorbidities in 181 Patients With Bipolar DisorderFrontiers in psychiatry · 2021Article
- Women's issues.Epileptic disorders : international epilepsy journal with videotape · 2020Article
- Lithium-associated hypothyroidism and potential for reversibility after lithium discontinuation: Findings from the LiSIE retrospective cohort study.Journal of psychopharmacology (Oxford, England) · 2020Article
- Rapid cycling bipolar disorder is associated with antithyroid antibodies, instead of thyroid dysfunction.BMC psychiatry · 2019Article
- Comprehensive comparison of monotherapies for psychiatric hospitalization risk in bipolar disorders.Bipolar disorders · 2018Article
- Using data-driven sublanguage pattern mining to induce knowledge models: application in medical image reports knowledge representation.BMC medical informatics and decision making · 2018Article
- Medical Comorbidities in Bipolar Disorder.Current psychiatry reports · 2018Review
- Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review.Therapeutics and clinical risk management · 2017Review
- Hypothyroidism risk compared among nine common bipolar disorder therapies in a large US cohort.Bipolar disorders · 2016Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThyroid abnormalities in patients with bipolar disorder (BD) have been linked to lithium treatment for decades, yet other drugs have been less well studied. Our objective was to compare hypothyroidism risk for lithium versus the anticonvulsants and second-generation antipsychotics commonly prescribed for BD.
methodsAdministrative claims data on 24,574 patients with BD were analyzed with competing risk survival analysis. Inclusion criteria were (i) one year of no prior hypothyroid diagnosis nor BD drug treatment, (ii) followed by at least one thyroid test during BD monotherapy on lithium carbonate, mood-stabilizing anticonvulsants (lamotrigine, valproate, oxcarbazepine, or carbamazepine) or antipsychotics (aripiprazole, olanzapine, risperidone, or quetiapine). The outcome was cumulative incidence of hypothyroidism per drug, in the presence of the competing risk of ending monotherapy, adjusted for age, sex, physician visits, and thyroid tests.
resultsAdjusting for covariates, the four-year cumulative risk of hypothyroidism for lithium (8.8%) was 1.39-fold that of the lowest risk therapy, oxcarbazepine (6.3%). Lithium was non-statistically significantly different from quetiapine. While lithium conferred a higher risk when compared to all other treatments combined as a group, hypothyroidism risk error bars overlapped for all drugs. Treatment (p = 3.86e-3), age (p = 6.91e-10), sex (p = 3.93e-7), and thyroid testing (p = 2.79e-87) affected risk. Patients taking lithium were tested for hypothyroidism 2.26-3.05 times more frequently than those on other treatments.
conclusionsThyroid abnormalities occur frequently in patients with BD regardless of treatment. Therefore, patients should be regularly tested for clinical or subclinical thyroid abnormalities on all therapies and treated as indicated to prevent adverse effects of hormone imbalances on mood.
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