Med/Psych Update

Treating thyroid disorders and depression: 3 case studies

Current Psychiatry. 2013 January;12(1):17-21

References

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Table 2

Hyperthyroidism symptoms

Psychiatric overlap
Decrease or increase in appetite
Insomnia
Fatigue
Mood instability
Irritability
Anxiety, nervousness
Somatic signs and symptoms
Frequent bowel movement, eg, diarrhea
Heart palpitations
Heat intolerance
Increased sweating
Light or missed menstrual periods, fertility problems
Muscle weakness
Shortness of breath
Sudden paralysis
Tremor, shakiness, dizziness
Vision changes
Weight loss or gain
Thinning of hair
Itching and hives
Possible increase in blood sugar

Using beta blockers to treat hyperthyroidism can help control tachycardia or palpitations, tremulousness, and anxiety that often are inherent in hyperthyroidism. But can beta blockers induce depressive symptoms? A 1-year prospective Dutch study of patients who had survived a myocardial infarction did not find evidence that beta blockers induced depressive symptoms.¹⁶ However, the long-term and high-dosage effects of beta blockers still are in question.¹⁶ In Mr. C’s case, beta blockers had only positive effects on his symptoms and did not exacerbate his depressive symptoms.

Clinical Point

A 1-year study of patients who survived a myocardial infarction did not find evidence that beta blockers induced depressive symptoms

Related Resources

National Women’s Health Resource Center, Inc. Thyroid disorders. www.healthywomen.org/condition/thyroid-disorders.
American Thyroid Association. www.thyroid.org.
American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. www.aace.com/files/hypo-hyper.pdf.

Drug Brand Names

Atenolol • Tenormin
Bupropion • Wellbutrin, Zyban
Citalopram • Celexa
Cyclobenzaprine • Flexeril
Divalproex ER • Depakote ER
Duloxetine • Cymbalta
Fluoxetine • Prozac
Lamotrigine • Lamictal
Levothyroxine • Levoxyl, Synthroid
Liothyronine sodium • Cytomel, Triostat
Lithium • Eskalith, Lithobid
Methimazole • Tapazole
Oxycodone • OxyContin
Paroxetine • Paxil
Sertraline • Zoloft
Sunitinib • Sutent

Disclosure

Dr. Raj is a speaker for AstraZeneca and Merck.