HOME HELP FEEDBACK SUBSCRIPTIONS ALL ISSUES SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a Colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shulman, K. I. Articles by Rochon, P. Search for Related Content PubMed PubMed Citation Articles by Shulman, K. I. Articles by Rochon, P.

New Thyroxine Treatment in Older Adults Beginning Lithium Therapy

Implications for Clinical Practice

Received September 27, 2004; revised October 29, November 16, 2004; accepted November 16, 2004. From the Dept. of Psychiatry and the Institute for Clinical Evaluative Sciences (ICES), Sunnybrook and Women’s College Health Sciences Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada, and the Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada (PR). Address correspondence and reprint requests to Dr. Kenneth I. Shulman, Dept. of Psychiatry, Sunnybrook and Women’s College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada. e-mail: Ken.Shulman{at}sw.ca
© 2005 American Association for Geriatric Psychiatry

Objective: The authors sought to determine the incidence of lithium-induced hypothyroidism in a population-based cohort of older adults beginning lithium therapy and thereby to inform clinical guidelines on the frequency of monitoring necessary in this group. Methods: The authors conducted a population-based observational cohort study using four administrative databases that contained information on over 1.3 million older adults in Ontario who receive universal healthcare coverage in terms of physician services, drugs, and hospitalizations. Over an 18-month period, they studied adults age 65 who were newly prescribed lithium or valproate, monitoring subjects for initiation of T₄ therapy (as a proxy for hypothyroidism) while they continued their lithium use. Results: The authors identified 1,705 new users of lithium and 2,406 new users of valproate with similar baseline characteristics. Lithium users were significantly more likely to be treated with T₄ than were valproate users. The rate of T₄ treatment per 100 person-years was 5.65 in the lithium group and 2.70 in the valproate group. Conclusion: T₄ treatment was initiated in almost 6% of lithium-treated patients, suggesting the possibility that hypothyroidism developed twice as frequently among these patients as would be expected among a mixed-age population. Increased vigilance and continued monitoring of thyroid functioning for at least 2 years is necessary in older adults beginning lithium therapy.

Key Words: Hypothyroidism • Thyroxine Treatment • Lithium • Bipolar Disorder

This article has been cited by other articles:

				R. C. Young Bipolar Disorder in Older Persons: Perspectives and New Findings Am J Geriatr Psychiatry, April 1, 2005; 13(4): 265 - 267. [Full Text] [PDF]