Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review

Objective: To investigate the final diagnosis and clinical outcome of pati ents referred to endocrinology in our district general hospital with biochemi cal isolated central hypothyroidism (CeH), and whether there is an association between this biochemical picture and treatment with antidepressant a...

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Main Authors: Frederick Keen, Anuja Chalishazar, Kelly Mitchem, Alan Dodd, Atul Kalhan
Format: Article
Language:English
Published: Bioscientifica 2023-01-01
Series:European Thyroid Journal
Subjects:
Online Access:https://etj.bioscientifica.com/view/journals/etj/11/2/ETJ-21-0119.xml
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author Frederick Keen
Anuja Chalishazar
Kelly Mitchem
Alan Dodd
Atul Kalhan
author_facet Frederick Keen
Anuja Chalishazar
Kelly Mitchem
Alan Dodd
Atul Kalhan
author_sort Frederick Keen
collection DOAJ
description Objective: To investigate the final diagnosis and clinical outcome of pati ents referred to endocrinology in our district general hospital with biochemi cal isolated central hypothyroidism (CeH), and whether there is an association between this biochemical picture and treatment with antidepressant and antipsychotic med ications. Methods: We performed a retrospective observational study of patients r eferred to endocrinology with unexplained biochemical isolated CeH over a 5-year period. Results: Of the 29 patients included in the study, 4 were found to have a partially empty or empty sella and 1 to have a bulky pituitary gland whic h was deemed to be an incidental radiological finding. No patients had any clinically significant pathology. On reviewing their medications, 18/29 (62%) were found to be on ps ychotropic medications. Conclusions: Our study suggests a relationship between patients on psychotr opic medications and biochemical isolated CeH, an association only described in a very limited amount of literature prior to this. The mechanism behind this may be suppression of TSH secretion via antagonism of the dopamine-ser otoninergic pathway. Determining a correlation between psychotropic medications and isolated CeH could lead to the avoidance of further radiological investigations an d unnecessary anxiety for patients. However, a larger observational study is needed to pr ovide further evidence to support/refute our finding.
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spelling doaj.art-41e0bf9499694e05a1dabd679a07f5b32023-01-12T10:15:11ZengBioscientificaEuropean Thyroid Journal2235-08022023-01-0111217https://doi.org/10.1530/ETJ-21-0119Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature reviewFrederick Keen0Anuja Chalishazar1Kelly Mitchem2Alan Dodd3Atul Kalhan4Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UKRoyal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UKRoyal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UKRoyal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UKRoyal Glamorgan Hospital, Ynysmaerdy, Llantrisant, UKObjective: To investigate the final diagnosis and clinical outcome of pati ents referred to endocrinology in our district general hospital with biochemi cal isolated central hypothyroidism (CeH), and whether there is an association between this biochemical picture and treatment with antidepressant and antipsychotic med ications. Methods: We performed a retrospective observational study of patients r eferred to endocrinology with unexplained biochemical isolated CeH over a 5-year period. Results: Of the 29 patients included in the study, 4 were found to have a partially empty or empty sella and 1 to have a bulky pituitary gland whic h was deemed to be an incidental radiological finding. No patients had any clinically significant pathology. On reviewing their medications, 18/29 (62%) were found to be on ps ychotropic medications. Conclusions: Our study suggests a relationship between patients on psychotr opic medications and biochemical isolated CeH, an association only described in a very limited amount of literature prior to this. The mechanism behind this may be suppression of TSH secretion via antagonism of the dopamine-ser otoninergic pathway. Determining a correlation between psychotropic medications and isolated CeH could lead to the avoidance of further radiological investigations an d unnecessary anxiety for patients. However, a larger observational study is needed to pr ovide further evidence to support/refute our finding.https://etj.bioscientifica.com/view/journals/etj/11/2/ETJ-21-0119.xmlcentral hypothyroidismantipsychoticsantidepressantspsychotropic medication
spellingShingle Frederick Keen
Anuja Chalishazar
Kelly Mitchem
Alan Dodd
Atul Kalhan
Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review
European Thyroid Journal
central hypothyroidism
antipsychotics
antidepressants
psychotropic medication
title Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review
title_full Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review
title_fullStr Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review
title_full_unstemmed Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review
title_short Central hypothyroidism related to antipsychotic and antidepressant medications: an observational study and literature review
title_sort central hypothyroidism related to antipsychotic and antidepressant medications an observational study and literature review
topic central hypothyroidism
antipsychotics
antidepressants
psychotropic medication
url https://etj.bioscientifica.com/view/journals/etj/11/2/ETJ-21-0119.xml
work_keys_str_mv AT frederickkeen centralhypothyroidismrelatedtoantipsychoticandantidepressantmedicationsanobservationalstudyandliteraturereview
AT anujachalishazar centralhypothyroidismrelatedtoantipsychoticandantidepressantmedicationsanobservationalstudyandliteraturereview
AT kellymitchem centralhypothyroidismrelatedtoantipsychoticandantidepressantmedicationsanobservationalstudyandliteraturereview
AT alandodd centralhypothyroidismrelatedtoantipsychoticandantidepressantmedicationsanobservationalstudyandliteraturereview
AT atulkalhan centralhypothyroidismrelatedtoantipsychoticandantidepressantmedicationsanobservationalstudyandliteraturereview