Effect of lithium on hypothalamic-pituitary-thyroid function in patients with affective disorders.

Hypothalamic-pituitary-thyroid (H.P.T.) function was assessed in 17 patients on maintenance doses of lithium carbonate for a mean period of 21 months (range 1-67 months) and by serial studies on four patients from the start of lithium treatment for a maximum of six months. An exaggerated thyrotrophin (TSH) response to intravenous thyrotrophin-releasing hormone (TRH) occurred in 14 of the 17 patients on maintenance treatment, though basal TSH levels were raised in only three. Two of the three patients were clinically and biochemically hypothyroid and showed a delayed recovery of normal H.P.T. function after lithium was stopped. There were no significant differences in thyroid hormone or basal TSH levels between the euthyroid lithium-treated.