Pharmacopsychiatry 2010; 43(6): 237-239
DOI: 10.1055/s-0030-1261880
Letter

© Georg Thieme Verlag KG Stuttgart · New York

Quetiapine-Associated Hypothyroidism in Young Female Patients: A Report of Three Cases

O. Poutanen1 , 3 , E. Iso-Koivisto1 , M. Työläjärvi2 , E. Leinonen1 , 3
  • 1Tampere University Hospital, Department of Psychiatry, Tampere, Finland
  • 2Tampere University Hospital, Department of Adolescent Psychiatry, Tampere, Finland
  • 3University of Tampere, Medical School, Tampere, Finland
Further Information

Publication History

received 29.12.2009 revised 22.03.2010

accepted 06.05.2010

Publication Date:
07 July 2010 (online)

Quetiapine is an atypical antipsychotic indicated for schizophrenia and bipolar disorder. In some rare cases quetiapine may induce a dose-related decrease in thyroxine levels. We present 3 cases of young female patients with various psychiatric diagnoses who presented with quetiapine-associated hypothyroidism, 2 of them with an increase in TSH. The time of recovery varied. Shorter times may be associated with discontinuation of quetiapine rather than with thyroxine substitution while continuing with quetiapine. Monitoring of thyroid function at least in quetiapine-treated patients with a history of or susceptibility to thyroid disease is recommended. If used concomitantly with other thyreostatics, such as lithium, this may also be warranted for young patients and those with high quetiapine doses. Further studies on the relevance of patients’ age and sex and on the reversibility of quetiapine-induced hypothyroidsim are needed.

References

  • 1 Seroquel (Quetiapine Fumarate) Product Monograph. Rev 05/09. Ontario, Canada: Astra Zeneca; 2009
  • 2 Beer F, Heinrich H, Springer S. et al . Quetiapine in the treatment of psychotic adolescents: a case series of 23 patients with severe early onset psychosis.  World J Biol Psychiatry. 2007;  8 38-41
  • 3 Castro-Fornieles J, Parellada M, Soutullo CA. et al . Antipsychotic treatment in child and adolescent first-episode psychosis: a longitudinal naturalistic approach.  J Child Adolesc Psychopharmacol. 2008;  18 327-336
  • 4 Chueire VB, Romaldini JH, Ward LS. Subclinical hypothyroidism increases the risk for depression in the elderly.  Arch Gerontol Geriatr. 2007;  44 21-28
  • 5 Gerlach M, Hunnerkopf R, Rothenhofer S. et al . Therapeutic drug monitoring of quetiapine in adolescents with psychotic disorders.  Pharmacopsychiatry. 2007;  40 72-76
  • 6 Greenspan A, Gharabawi G, Kwentus J. Thyroid dysfunction during treatment with atypical antipsychotics.  J Clin Psychiatry. 2005;  66 1334-1335
  • 7 Guimaraes JM, de Souza Lopes C, Baima J. et al . Depression symptoms and hypothyroidism in a population-based study of middle-aged Brazilian women.  J Affect Disord. 2009;  117 120-123
  • 8 Kelly DL, Conley RR. Thyroid function in treatment-resistant schizophrenia patients treated with quetiapine, risperidone, or fluphenazine.  J Clin Psychiatry. 2005;  66 80-84
  • 9 Kontaxakis VP, Karaiskos D, Havaki-Kontaxaki BJ. et al . Can quetiapine-induced hypothyroidism be reversible without quetiapine discontinuation?.  Clin Neuropharmacol. 2009;  32 295-296
  • 10 McConville B, Carrero L, Sweitzer D. et al . Long-term safety, tolerability, and clinical efficacy of quetiapine in adolescents: an open-label extension trial.  J Child Adolesc Psychopharmacol. 2003;  13 75-82
  • 11 McConville BJ, Arvanitis LA, Thyrum PT. et al . Pharmacokinetics, tolerability, and clinical effectiveness of quetiapine fumarate: an open-label trial in adolescents with psychotic disorders.  J Clin Psychiatry. 2000;  61 252-260
  • 12 Shaw JA, Lewis JE, Pascal S. et al . A study of quetiapine: efficacy and tolerability in psychotic adolescents.  J Child Adolesc Psychopharmacol. 2001;  11 415-424
  • 13 Traynor K. FDA advisers wary of expanding quetiapine use: clinicians air concerns about metabolic effects, tardive dyskinesia.  Am J Health Syst Pharm. 2009;  66 880-882
  • 14 Walsh JP, Bremner AP, Bulsara MK. et al . Thyroid dysfunction and serum lipids: a community-based study.  Clin Endocrinol (Oxf). 2005;  63 670-675

Correspondence

O. PoutanenMD, PhD 

Tampere University Hospital

Department of Psychiatry

33380 Pitkäniemi

Finland

Phone: +358/50/306 8159

Fax: +358/33/116 3655

Email: outi.poutanen@uta.fi

    >