Lithium as an Adjunct to Radioiodine Therapy for Thyrotoxicosis

Turner, John G.; Brownlie, B. E. W.; Rogers, T. G. H.

doi:10.1016/s0140-6736(76)90419-0

Cited by 71 publications

(40 citation statements)

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“…Previous observations indicated that lithium inhibits the release of radioiodine from the thyroid, thereby prolonging the biological half-life of 131 1 (Sedvall et al 1968;Berens et al 1970;Spaulding et al 1972;Turner et al 1976). Our increase in the thyroid biological half-life of 131 1 is in agreement with these findings.…”

Section: Discussionsupporting

confidence: 92%

“…Earlier studies (Burrow et al 1971;Spaulding et al 1972) showed that the administration of lithium increased the retention of 131 1 in the thyroid gland. These observations were further confirmed by Turner et al (1976). The increase in the values of Tbiol and Terr were more or less the same in groups of rats treated with lithium for 2, 4 and 6 months.…”

Section: Discussionsupporting

confidence: 65%

See 1 more Smart Citation

Effect of Short-term and Long-term Lithium Treatment on Uptake and Retention of 10dine-131 in Rat Thyroid

Dhawan¹,

Sharma²,

Sharma³

et al. 1988

Aust. Jnl. Of Bio. Sci.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 65%

Effect of Short-term and Long-term Lithium Treatment on Uptake and Retention of 10dine-131 in Rat Thyroid

Dhawan¹,

Sharma²,

Sharma³

et al. 1988

Aust. Jnl. Of Bio. Sci.

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“…However, patients may be unduly suspicious about radiation so that reassurance and education are vital. If lithium therapy is still necessary this can be continued during 131 I therapy as lithium can be helpful by prolonging intrathyroidal 131 I retention (19). If a patient with TP wishes to avoid radioiodine, long-term carbimazole is the alternative but this seems best combined with T 4 to avoid iatrogenic hypothyroidism (Case 9 had recurrent psychosis with hypothyroidism).…”

Section: European Journal Of Endocrinology (2000) 142mentioning

confidence: 99%

Psychoses associated with thyrotoxicosis - 'thyrotoxic psychosis.' A report of 18 cases, with statistical analysis of incidence

Brownlie

Rae²,

Walshe³

et al. 2000

European Journal of Endocrinology

118

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Objective: To report a series of newly diagnosed thyrotoxic patients with concurrent acute psychosis, and to assess the association between the two disorders. Design: Retrospective study of thyrotoxic patients with associated psychosis ('thyrotoxic psychosis'; TP) requiring inpatient psychiatric care. New Zealand thyrotoxicosis annual incidence figures and first psychiatric admission rates for affective psychosis were utilised to statistically assess the co-occurrence of thyrotoxicosis and affective psychosis. Patients and Methods: During the 20-year study period, 18 inpatients (16 women and 2 men), mean age 54 years, with TP were identified. No patient had a past history of thyrotoxicosis, but four had required psychiatric inpatient care many years earlier. Thyrotoxicosis was documented by radioimmunoassay of thyroid hormone levels, and thyroid scintiscan. Psychiatric manifestations were classified using ICD9 criteria. Results: Thyroid hormone levels were markedly elevated in more than half of our TP patients. All younger patients had Graves' disease, and most older patients toxic nodular goitre. All patients were treated with antithyroid drugs, and all but one subsequently received 131 I therapy. Two patients were not mentally ill when thyrotoxicosis was diagnosed, but suffered major mood swings when thyroid hormone levels were falling. There was no specific psychiatric clinical picture but affective psychoses were commonest -seven depression, seven mania. The other diagnoses were two schizophreniform, one paranoid, and one delirium. Initially, neuroleptic medication was used in all but one patient, and during long-term follow-up (median 11 years) more than half our series had remained well with no further psychiatric problems. Statistical analysis was restricted to thyrotoxic patients with first psychiatric hospital admission for affective psychosis. During the 20-year period, there were nine thyrotoxic patients (95% confidence interval 4.5-17.1) with concurrent affective psychosis requiring first admission, and the calculated expected number was only 0.36. These findings indicate a clear association well above chance co-occurrence. Conclusion: TP is not a specific clinical picture, but affective psychoses are commonest. Statistical analysis of thyrotoxic patients with concurrent affective psychoses showed an incidence well above chance co-occurrence. It appears that thyrotoxicosis may be a precipitant of acute affective psychosis.

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“…Due to the potential to prolong the retention of intrathyroidal iodine [40], lithium can potentially increase the efficacy in radioiodine treatment of hyperthyroid patients. It has been estimated that lithium can prolong the effective half-life of iodine-131 by 50%, which can lower the administered dose while maintaining the effective dose [41].…”

Section: Radioactive Iodine-131 Therapy Adjunctmentioning

confidence: 99%