Thyrotoxicosis after Iodine Contrast Medium Administration: Rapid Mood Swing to Mania and Subsequent Psychotic Depression in a Patient with Bipolar Disorder during Lithium Therapy

Interactions between lithium treatment and thyroid function are well known and the risk of hypothyroidism is widely recognized by clinicians. In addition, a higher presence of thyroid antibodies has been described in bipolar disorders independent of lithium exposure. We present a case of severe thyrotoxicosis with a rapid mood swing to mania and subsequent psychotic depression in a 56-year-old woman with bipolar disorder during lithium therapy following the administration of iodine contrast medium. On the basis of this case report and existing literature it seems advisable to closely monitor not only thyroid hormones but also thyroid antibodies in patients with bipolar disorders.

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