Thyroid disease, behavior, and psychopharmacology

The authors review psychiatric complications of thyroid disease and the use of psychotropic agents in hyper- and hypothyroid patients. Neuropsychiatric symptoms of hyperthyroidism tend to resolve with treatment of excessive thyroid production; those of hypothyroidism respond in a variable manner to thyroid replacement, but most patients improve substantially after becoming euthyroid. The judicious use of most psychotropics has its place even in the presence of overt thyroid disease. The important antithyroid effects of lithium should be noted when treating patients with thyroid disease. Routine monitoring of thyroid function in otherwise healthy patients taking antipsychotic agents, tricyclic antidepressants, or monoamine oxidase inhibitors (MAOIs) is not believed necessary.