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Hypothyroidism, Psychotropic Drugs and Cardiotoxicity

Published online by Cambridge University Press:  29 January 2018

Joan Gomez
Affiliation:
Westminster Hospital, London SW1
Geoffrey Scott
Affiliation:
Westminster Hospital; now Searle Research Fellow Clinical Research Centre, Harrow

Extract

The effects of hypothyroidism are protean, involving many systems. Electrocardiographic changes are almost invariable, and include bradycardia, low QRS voltage and flattened T waves: these are usually reversible with replacement therapy (McDonald, 1978). Psychiatric disturbances are also well known, although they are seldom the presenting feature and are notorious for mistakes in diagnosis (Lishman, 1978; Whybrow and Ferrell, 1974). Most such disturbances comprise apathy and depression, some an organic reaction and a few manifest as an acute schizophrenia-like psychosis. Phenothiazines, the most generally used neuroleptic medication, may interfere with cardiac conduction. When hypothyroidism presents as acute psychosis and the patient is hypersensitive to phenothiazines a dangerous situation can arise.

Type
Papers
Copyright
Copyright © The Royal College of Psychiatrists 

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