A case of mood disorder with severe side effects of antidepressants in association with resistance to thyroid hormone beta with a THRB mutation

Abstract

Psychiatric disorders are highly integrated with thyroid disorders; T3 is closely related to depression and anxiety because of its ability to regulate serotonin and noradrenaline. 1 It is also known that psychiatric symptoms often persist after thyroid function is normalized by treatment. 1 In addition, previous studies have shown that bipolar disorder is closely related to thyroid dysfunction. Psychiatric medications can affect thyroid function to a greater or lesser extent, and thyroid hormone (TH) levels can also affect the effectiveness of medications, 2 while thyroid autoimmunity has been suggested to be an independent risk factor for mood disorders. 3 Thyroid hormone resistance (RTH) is a clinical syndrome defined by decreased sensitivity to TH, commonly caused by mutations in the thyroid hormone receptor beta (RTHβ) gene, and referred to as RTH beta or Refetoff syndrome. 4 The exact incidence of RTHβ is unknown because RTHβ is rarely detected by routine thyroidstimulating hormone (TSH)-based newborn screening programs, but