Quetiapine and Valproic Acid-induced Central Hypothyroidism in a Patient with Autism Spectrum Disorder and Intractable Epilepsy: A Case Report

Title:Quetiapine and Valproic Acid-induced Central Hypothyroidism in a Patient with Autism Spectrum Disorder and Intractable Epilepsy: A Case Report

Volume: 24 Issue: 13

Author(s): Narantsatsral Daramjav, Junko Takagi*, Hideyuki Iwayama, Kousuke Kanemoto and Kazuo Otake

Affiliation:

• Division of Endocrinology and Metabolism, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan

Abstract:

Objectives: Patients with an autism spectrum disorder (ASD) are prone to disruptive behaviors and aggression. A typical antipsychotics are used to treat these difficult ASD conditions. Several psychotropic drugs have been linked to hypothyroidism. The clinical manifestation of hypothyroidism is indistinguishable from that of an antipsychotic’s general adverse effect, which can lead to a delayed or missed diagnosis. Conversely, thyroid dysfunction can exhibit an impact on mood, anxiety, depression, and cognitive functions.

Case Presentation: We present a case of central hypothyroidism caused by long-term use of valproic acid (VPA) and adding quetiapine to risperidone. The current case had a history of hyperprolactinemia and subclinical hypothyroidism caused by risperidone and VPA, respectively, before the administration of quetiapine.

Conclusion: This is the first report of quetiapine-induced central hypothyroidism in a patient with ASD, as determined by a thyrotropin-releasing hormone (TRH) loading test. TRH loading test may be useful in elucidating the pathogenesis of hypothyroidism in patients receiving quetiapine and VPA. Thyroid function monitoring in patients taking quetiapine and VPA may provide an opportunity to begin replacement therapy.

Cite this article as:

Daramjav Narantsatsral, Takagi Junko*, Iwayama Hideyuki, Kanemoto Kousuke and Otake Kazuo, Quetiapine and Valproic Acid-induced Central Hypothyroidism in a Patient with Autism Spectrum Disorder and Intractable Epilepsy: A Case Report, Endocrine, Metabolic & Immune Disorders - Drug Targets 2024; 24 (13) . https://dx.doi.org/10.2174/0118715303261457231120114231