Login Register Cart 0
Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Case Report

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

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

Volume 24, Issue 13, 2024

Published on: 19 January, 2024

Page: [1581 - 1585] Pages: 5

DOI: 10.2174/0118715303261457231120114231

Price: $65

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.

« Previous
[1]
Posey, D.J.; Stigler, K.A.; Erickson, C.A.; McDougle, C.J. Antipsychotics in the treatment of autism. J. Clin. Invest., 2008, 118(1), 6-14.
[http://dx.doi.org/10.1172/JCI32483] [PMID: 18172517]
[2]
Garver, D.L. Review of quetiapine side effects. J. Clin. Psychiatry, 2000, 61(Suppl. 8), 31-33. [Art no.].
[PMID: 10811241]
[3]
Khoodoruth, M.A.S.; Abdo, A.K.A.; Ouanes, S. Quetiapine‐Induced Thyroid Dysfunction: A Systematic Review. J. Clin. Pharmacol., 2022, 62(1), 20-35.
[http://dx.doi.org/10.1002/jcph.1960] [PMID: 34467533]
[4]
Feret, B.M.; Caley, C.F. Possible hypothyroidism associated with quetiapine. Ann. Pharmacother., 2000, 34(4), 483-486.
[http://dx.doi.org/10.1345/aph.19186] [PMID: 10772436]
[5]
Kontaxakis, V.P.; Karaiskos, D.; Havaki-Kontaxaki, B.J.; Ferentinos, P.; Papadimitriou, G.N. Can quetiapine-induced hypothyroidism be reversible without quetiapine discontinuation? Clin. Neuropharmacol., 2009, 32(5), 295-296.
[http://dx.doi.org/10.1097/WNF.0b013e3181a8cbcc] [PMID: 19820433]
[6]
Zenno, A.; Leschek, E. Quetiapine-induced central hypothyroidism. J. Am. Acad. Child Adolesc. Psychiatry, 2020, 59(5), 575-576.
[http://dx.doi.org/10.1016/j.jaac.2020.01.018] [PMID: 32036034]
[7]
Tor, P.C.; Lee, H.Y.; Foness, C.S. Late-onset mania with psychosis associated with hypothyroidism in an elderly Chinese lady. Singapore Med. J., 2007, 48(4), 354-357.
[8]
Poutanen, O.; Iso-Koivisto, E.; Työläjärvi, M.; Leinonen, E. Quetiapine-associated hypothyroidism in young female patients: a report of three cases. Pharmacopsychiatry, 2010, 43(6), 237-239.
[http://dx.doi.org/10.1055/s-0030-1261880] [PMID: 20614417]
[9]
Dobbs, R.L.; Brahm, N.C.; Fast, G.; Brown, R.C. Thyroid function alterations following quetiapine initiation in a developmentally disabled adolescent. Ann. Pharmacother., 2004, 38(9), 1541-1542.
[http://dx.doi.org/10.1345/aph.1E054] [PMID: 15252194]
[10]
Shoib, S.; Dar, M.M.; Arif, T.; Bashir, H.; Ahmeds, J. Subclinical hypothyroidism as a result of quetiapine therapy; J. Pak. Med. Stud, 2013, pp. 22-23.
[11]
Dreijerink, K.M.A.; Kampschreur, L.M.; Lentjes, E.G.W.M.; Lokhorst, B.; Zelissen, P.M.J. Atypical hypocortisolism. Endocr. Pract., 2013, 19(5), e112-e114.
[http://dx.doi.org/10.4158/EP12415.CR] [PMID: 23757611]
[12]
Ramaswamy, S.; Siddiqui, Z.; Saharan, S.; Gabel, T.L.; Bhatias, S.C. Quetiapine-induced hypothyroidism. J. Psychiatry Neurosci., 2005, 30(1), 57.
[13]
Park, Y.M.; Kang, S.G.; Lee, B.H.; Lees, H.J. Decreased thyroid function in Korean women with bipolar disorder receiving valproic acid. Gen. Hosp. Psychiatry, 2011, 200 (2), 200 e13-e15.
[http://dx.doi.org/10.1016/j.genhosppsych.2010.11.008]
[14]
Liappas, J.; Paparrigopoulos, T.; Mourikis, I.; Soldatos, C. Hypothyroidism induced by quetiapine: a case report. J. Clin. Psychopharmacol., 2006, 26(2), 208-209.
[http://dx.doi.org/10.1097/01.jcp.0000203227.56494.ff] [PMID: 16633154]
[15]
Besag, F. Epilepsy in patients with autism: links, risks and treatment challenges. Neuropsychiatr. Dis. Treat., 2017, 14, 1-10.
[http://dx.doi.org/10.2147/NDT.S120509] [PMID: 29296085]
[16]
Bou Khalil, R.; Richa, S. Thyroid adverse effects of psychotropic drugs: a review. Clin. Neuropharmacol., 2011, 34(6), 248-255.
[http://dx.doi.org/10.1097/WNF.0b013e31823429a7] [PMID: 21996646]
[17]
Scanlon, M.F.; Weightman, D.R.; Shale, D.J.; Mora, B.; Heath, M.; Snow, M.H.; Lewis, M.; Hall, R. Dopamine is a physiological regulator of thyrotrophin (TSH) secretion in normal man. Clin. Endocrinol. (Oxf.), 1979, 10(1), 7-15.
[http://dx.doi.org/10.1111/j.1365-2265.1979.tb03028.x] [PMID: 436307]
[18]
Besses, G.S.; Burrow, G.N.; Spaulding, S.W.; Donabedian, R.K.; Pechinski, T. Dopamine infusion acutely inhibits the TSH and prolactin response to TRH. J. Clin. Endocrinol. Metab., 1975, 41(5), 985-988.
[http://dx.doi.org/10.1210/jcem-41-5-985] [PMID: 810492]
[19]
Vainionpää, L.K.; Mikkonen, K.; Rättyä, J.; Knip, M.; Pakarinen, A.J.; Myllylä, V.V.; Isojärvi, J.I.T. Thyroid function in girls with epilepsy with carbamazepine, oxcarbazepine, or valproate monotherapy and after withdrawal of medication. Epilepsia, 2004, 45(3), 197-203.
[http://dx.doi.org/10.1111/j.0013-9580.2004.26003.x] [PMID: 15009219]
[20]
Bo, Q.; Dong, F.; Li, X.; Wang, Z.; Ma, X.; Wang, C. Prolactin related symptoms during risperidone maintenance treatment: results from a prospective, multicenter study of schizophrenia. BMC Psychiatry, 2016, 16(1), 386.
[http://dx.doi.org/10.1186/s12888-016-1103-3] [PMID: 27829454]
[21]
Torre, D.L.; Falornis, A. Pharmacological causes of hyperprolactinemia. Ther. Clin. Risk. Manag., 2007, 3(5), 929-951. https://www.ncbi.nlm.nih.gov/pubmed/18473017
[22]
Peuskens, J.; Pani, L.; Detraux, J.; De Hert, M. The effects of novel and newly approved antipsychotics on serum prolactin levels: a comprehensive review. CNS Drugs, 2014, 28(5), 421-453.
[http://dx.doi.org/10.1007/s40263-014-0157-3] [PMID: 24677189]
[23]
Elman, I.; Goldstein, D.S.; Green, A.I.; Eisenhofer, G.; Folio, C.J.; Holmes, C.S.; Pickar, D.; Breier, A. Effects of risperidone on the peripheral noradrenegic system in patients with schizophrenia: a comparison with clozapine and placebo. Neuropsychopharmacology, 2002, 27(2), 293-300.
[http://dx.doi.org/10.1016/S0893-133X(02)00314-7] [PMID: 12093603]
[24]
Gefvert, O.; Bergström, M.; Långström, B.; Lundberg, T.; Lindström, L.; Yates, R. Time course of central nervous dopamine-D 2 and 5-HT 2 receptor blockade and plasma drug concentrations after discontinuation of quetiapine (Seroquel ®) in patients with schizophrenia. Psychopharmacology, 1998, 135(2), 119-126.
[http://dx.doi.org/10.1007/s002130050492] [PMID: 9497016]
[25]
Lania, A.; Persani, L.; Beck-Peccozs, P. Central hypothyroidism. Pituitary, 2008, (2), 181-186.
[http://dx.doi.org/10.1007/s11102-008-0122-6]
[26]
Faglia, G. The clinical impact of the thyrotropin-releasing hormone test. Thyroid, 1998, 8(10), 903-908.
[http://dx.doi.org/10.1089/thy.1998.8.903] [PMID: 9827657]
[27]
Atmaca, H.; Tanriverdi, F.; Gokce, C.; Unluhizarci, K.; Kelestimur, F. Do we still need the TRH stimulation test? Thyroid, 2007, 17(6), 529-533.
[http://dx.doi.org/10.1089/thy.2006.0311] [PMID: 17614773]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy