Lowered quality of life in mood disorders is associated with increased neuro-oxidative stress and basal thyroid-stimulating hormone levels and use of anticonvulsant mood stabilizers

Mood disorders represent a main health concern, due to their high prevalence in the general population and because they are related to a severe worsening of quality of life and psychosocial functioning of those who are affected. Because of the importance of such diseases, that, according to WHO, might become the major cause of morbidity by 2020, an efficacious, targeted and precise approach is essential in everyday clinical practice. This article reviews the methods of diagnostic approach, with the aim of describing the different phases of nosographic classification of mood disorders and their meaning. In particular, the most reliable classification distinguishes between unipolar (major depressive disorder) and bipolar (type I and II) disorders: the right differential diagnosis is important because there are great differences in the optimal management of these conditions (antidepressants vs. mood stabilizers) and diagnostic errors can potentially worsen the patient’s prognosis. In conclusion, the right nosographic classification allows the right therapeutic and prognostic approach. This may result in higher rates of remission and response, thus improving patient’s quality of life and overall wellness.http://dx.doi.org/10.7175/rhc.v3i3.200

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THE EFFECT OF ANTICONVULSANT DRUGS ON SERUM THYROID-STIMULATING HORMONE

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2021.v14i5.41329 ◽

2021 ◽

pp. 144-146

Author(s):

NEETHU T T ◽

SYAM S ◽

BEENA V ◽

DHANYA S P

Keyword(s):

Quality Of Life ◽

Thyroid Function ◽

Sodium Valproate ◽

Thyroid Stimulating Hormone ◽

Control Group ◽

Significant Difference ◽

Epileptic Patients ◽

The Mean ◽

Stimulating Hormone

Objective: Antiepileptic (AED) drugs are an integral component of the management of seizure disorder; however, they have a wide spectrum of adverse effects. It is important to be aware of these side effects as they have a major impact on the quality of life and are sometimes partially reversible after drug discontinuation. Among them, the influence of AED on thyroid function is an important one. However, there is only limited data available. The objective of this study is to evaluate the effect of AED on thyroid-stimulating hormone (TSH). Methods: A cross-sectional study of 1-year duration (march 2017 – march 2018) was conducted among 150 epileptic patients receiving phenytoin, carbamazepine, and sodium valproate for more than 6 months in a tertiary care center in central Kerala. Serum levels of TSH of patients on AED were compared with that of 50 healthy age- and sex-matched control groups. Data regarding the same were analyzed using SPSS version 16 with the Chi-square test, ANOVA, and independent t-test. Results: A total of 150 epileptic patients with a mean age of 35.54 + 10.72, including 66 males (44%) and 84 females (56%) were enrolled in this study. Fifty adults of mean age 36.5+ 8.4 and male to female ratio 1.10:1 formed the control group. It was found that the mean TSH value of patients on phenytoin (3.97+ 1.47), carbamazepine (3.57+ 1.44), and sodium valproate 3.03 + 1.41 significantly higher than that of the control group (1.91 + 0.72). On comparing the mean serum TSH of the drug group significant difference noted between phenytoin and sodium valproate treated group. Among the 12 patients develop subclinical hypothyroidism 65% taking drugs for more than 5 years. Conclusion: There is a positive correlation between the use of anticonvulsants and thyroid dysfunction and the association increases with the duration of therapy. The clinicians should be encouraged for regular monitoring of thyroid function test to impart a better quality of life to the patients.

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Long-Term Results after Treatment of Very Low-, Low-, and High-Risk Thyroid Cancers in a Combined Setting of Thyroidectomy and Radio Ablation Therapy in Euthyroidism

International Journal of Endocrinology ◽

10.1155/2013/769473 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Nikos Emmanouilidis ◽

Harald Schrem ◽

Michael Winkler ◽

Jürgen Klempnauer ◽

Georg F. W. Scheumann

Keyword(s):

Quality Of Life ◽

High Risk ◽

Job Performance ◽

Sick Leave ◽

Tumor Recurrence ◽

Thyroid Stimulating Hormone ◽

Human Thyroid ◽

Thyroid Cancers ◽

Stimulating Hormone

Introduction. Differentiated thyroid cancer treatment usually consists of thyroidectomy and radio ablation in hypothyroidism 4-6 weeks after surgery. Replacing hypothyroidism by recombinant human thyroid stimulating hormone can facilitate radio ablation in euthyroidism within one week after surgery. The outcome of this approach was investigated.Methods. This is a prospective randomized trial to compare thyroidectomy and radio ablation within a few days after preconditioning with recombinant human thyroid stimulating hormone versus thyroidectomy and radio ablation separated by four weeks of L-T4withdrawal. Tumors were graded into very low-, low- , or high-risk tumors. Recurrence-free survival was confirmed at follow-up controls by neck ultrasound and serum thyroglobulin. Suspected tumor recurrence was treated by additional radio ablation or surgery. Quality-of-life questionnaires with additional evaluation of job performance and sick-leave time were used in all patients.Results. Radio ablation in euthyroidism in quick succession after thyroidectomy did not lead to higher tumor recurrence rates of differentiated thyroid cancers in any risk category and was significantly advantageous with respect to quality-of-life (P<0.001), sick-leave time (P<0.001), and job performance (P=0.002).Conclusion. Recombinant human thyroid stimulating hormone can be used safely and with good efficacy to allow radio ablation under sustained euthyroidism within one week after thyroidectomy.

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Thyrotropin levels and severity of symptoms in migraine patients of tertiary headache center

Cephalalgia ◽

10.1177/0333102418794941 ◽

2018 ◽

Vol 39 (1) ◽

pp. 148-152 ◽

Cited By ~ 5

Author(s):

Natalia L Starikova ◽

Tatiana V Baidina ◽

Tatiana P Kalashnikova

Keyword(s):

Quality Of Life ◽

Thyroid Stimulating Hormone ◽

Current Therapy ◽

Life Questionnaire ◽

Open Label ◽

Cross Sectional ◽

Quality Of Life Questionnaire ◽

Headache Center ◽

Stimulating Hormone

Background The role of thyroid regulation in migraine is poorly understood, and data is contradictory. Objective To study the possible association of clinical features of migraine with patients’ thyroid function. Patients and methods One hundred and thirty migraine patients of a tertiary headache center took part in an open-label, cross-sectional comparative study. The Migraine Disability Assessment questionnaire, Spielberger State-Trait Anxiety Inventory, Beck Depression Inventory, Vanderbilt’s Questionnaire of Pain Management, Gothenburg Quality of Life Questionnaire and Migraine-Specific Quality of Life questionnaire were used. The effectiveness of the attacks’ therapy was assessed according to the Migraine Assessment of Current Therapy questionnaire. Levels of thyrotropine (thyroid stimulating hormone), thyroxine, and triiodothyronine were studied by standard immune chemiluminescent method using the Immulite-2000 set. Results An inverse correlation between levels of thyroid stimulating hormone in serum and duration of headache attacks was revealed. The effectiveness of abortive therapy for attacks showed a statistically significant positive correlation with thyroid stimulating hormone level. Quality of life measured by a general quality of life questionnaire, as well as the functional and social indices of a migraine-specific questionnaire, showed direct correlation with serum thyroid stimulating hormone. Conclusion These results show an association of a more severe clinical course of migraine with lower thyroid stimulating hormone levels.

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Short-term Withdrawal of Levothyroxine, Induced Increase of Thyroid-stimulating Hormone and an Increase Ratio of Triiodothyronine to Thyroxine

European Endocrinology ◽

10.17925/ee.2013.09.01.37 ◽

2010 ◽

Vol 9 (1) ◽

pp. 37

Author(s):

Martin Carlwe ◽

Thomas Schaffer ◽

◽

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Thyroid Stimulating Hormone ◽

Complete Regression ◽

Free T4 ◽

Dosing Intervals ◽

Hypothyroid Patients ◽

Tsh Levels ◽

Stimulating Hormone

Objective:Treatment with levothyroxine in primary hypothyroid patients does not always provide complete regression of associated symptoms despite normalised TSH levels. Several sources report ratios of triiodothyronine (T3) to thyroxine (T4) are diminished in hypothyroid patients following a daily levothyroxine regimen. It is known that thyroid-stimulating hormone (TSH) increases de-iodination of T4 to T3. We hypothesise that a raise in TSH levels caused by a temporary withdrawal of oral levothyroxine will be followed by an increased conversion of T4 to T3.Methods:Thirteen patients treated with monotherapy of levothyroxine were included in our pilot study. Treatment was temporarily discontinued for one week in which TSH, free T3 (fT3) and free T4 (fT4) were monitored. TSH and fT3 to fT4 ratios were compared with baseline values.Results:Statistically significant elevations in TSH and fT3 plasma levels relative to fT4 were demonstrated in all patients after withdrawal of levothyroxine.Conclusion:Both TSH and fT3 to fT4 ratios rose following temporary discontinuation of levothyroxine. The effect on symptoms and quality of life is not evaluated in this pilot study. Our results warrant further investigation into whether or not longer dosing intervals would demonstrate commensurate hormone elevations that better reflects the hormonal ratios in healthy subjects and if this also has an effect on quality of life scores.

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Nosographic classification of mood disorders: from symptoms to diagnosis and treatment

Reviews in Health Care ◽

10.7175/rhc.20033179-191 ◽

2012 ◽

Vol 3 (3) ◽

pp. 179

Author(s):

Umberto Albert ◽

Andrea Aguglia ◽

Francesca Barbaro ◽

Giuseppe Maina ◽

Filippo Bogetto

Keyword(s):

Quality Of Life ◽

Mood Disorders ◽

Psychosocial Functioning ◽

Diagnostic Errors ◽

Mood Stabilizers ◽

Health Concern ◽

Type I ◽

The Right

Mood disorders represent a main health concern, due to their high prevalence in the general population and because they are related to a severe worsening of quality of life and psychosocial functioning of those who are affected. Because of the importance of such diseases, that, according to WHO, might become the major cause of morbidity by 2020, an efficacious, targeted and precise approach is essential in everyday clinical practice. This article reviews the methods of diagnostic approach, with the aim of describing the different phases of nosographic classification of mood disorders and their meaning. In particular, the most reliable classification distinguishes between unipolar (major depressive disorder) and bipolar (type I and II) disorders: the right differential diagnosis is important because there are great differences in the optimal management of these conditions (antidepressants vs. mood stabilizers) and diagnostic errors can potentially worsen the patient’s prognosis. In conclusion, the right nosographic classification allows the right therapeutic and prognostic approach. This may result in higher rates of remission and response, thus improving patient’s quality of life and overall wellness.http://dx.doi.org/10.7175/rhc.v3i3.200

Download Full-text