Treating thyroid disorders and depression: 3 case studies
Recognizing clinical nuances can improve screening and treatment of both disorders
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.
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.
