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Hypothyroidism, Psychotropic Drugs and Cardiotoxicity

Published online by Cambridge University Press:  29 January 2018

Joan Gomez  and
Geoffrey Scott
Joan Gomez
Affiliation:
Westminster Hospital, London SW1
Geoffrey Scott
Affiliation:
Westminster Hospital; now Searle Research Fellow Clinical Research Centre, Harrow
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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
Information
The British Journal of Psychiatry , Volume 136 , Issue 1 , January 1980 , pp. 89 - 91
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Alvarez Mena, S. C. & Frank, M. J. (1973) Phenothiazine-induced T-wave abnormalities. Journal of the American Medical Association, 224, 1730–3.Google ScholarPubMed
Asher, R. (1949) Myxoedematous madness. British Medical Journal, ii, 555–62.Google Scholar
Bayliss, R. I. S. (1978) The thyroid gland. In Price's Textbook of the Practice of Medicine, 12 edition, ed. Sir Ronald Bodley Scott. Oxford University Press.Google Scholar
Browning, T. B., Atkins, R. W. & Weiner, H. (1954) Cerebral metabolic disturbances in hypothyroidism: clinical and electroencephalographic studies of the psychoses of myxoedema and hypothyroidism. Archives of Internal Medicine, 93, 367–77.Google ScholarPubMed
Gibson, J. G. (1962) Emotions and the thyroid gland: a critical appraisal. Journal of Psychosomatic Research, 6, 93–116.CrossRefGoogle ScholarPubMed
Hall, R., Anderson, J., Smart, G. A. & Besser, M. (1974) Chapter 5, Thyroid, in Fundamentals of Clinical Endocrinology. 2nd edition. London: Pitman Medical.Google Scholar
Hoffenberg, R. (1978) The Thyroid. Medicine, 3, 392–404.Google Scholar
Hollister, L. E. & Kosek, J. C. (1965) Sudden death during treatment with phenothiazine derivatives. Journal of the American Medical Association, 192, 1035–8.Google ScholarPubMed
Jeeva Raj, M. V. & Benson, R. (1975) Phenothiazines and the electrocardiogram. Postgraduate Medical Journal, 51, 65–8.Google ScholarPubMed
Kelly, H. G., Fay, J. E. & Laverty, S. G. (1963) Thioridazine hydrochlotide: its effect on the cardiogram and a report of two fatalities with electrocardiographic abnormalities. Canadian Medical Association Journal, 89, 554–64.Google Scholar
Landmark, K. H. (1970) Cardiac effects of phenothiazines. Nordisk Median, 83, 617–720.Google Scholar
Levine, D. F. & Marshall, A. J. (1975) Cardiac arrhythmia induced by phenothiazines. Lancet, ii, 990 (letter).Google Scholar
Lingjaerde, O. (1967) Electrocardiographic changes, disturbances in cardiac rhythm and sudden death during phenothiazine treatment. Tidsskrift for den Norske Haegeforening, 67, 90–4.Google Scholar
Lishman, W. A. (1978) Chapter 11, Endocrine Diseases. In Organic Psychiatry, London: Blackwell.Google Scholar
McDonald, A. (1978) Heart disease in various systemic diseases. In Price's Textbook of Medicine (vs).Google Scholar
Moore, M. T. & Book, M. H. (1970) Sudden death in phenothiazine therapy. Psychiatric Quarterly, 44, 389–402.CrossRefGoogle ScholarPubMed
Pratt, I. T. (1971) Twilight sleep after infarction. British Medical Journal, iii, 475–6 (letter).Google Scholar
Rosenquist, R. J., Bauer, W. W. & Mork, J. N. (1971) Recurrent major ventricular arrhythmias associated with thioridazine therapy. Minnesota Medicine, 54, 877–80.Google ScholarPubMed
Sydney, M. A. (1973) Ventricular arrhythmias associated with the use of thioridazine hydrochloride in alcohol withdrawal. British Medical Journal, iv, 467–70.Google Scholar
Tranum, W. K. & Murphy, M. K. (1969) Case report: successful treatment of ventricular tachycardia associated with thioridazine. Southern Medical Journal, 62, 357–8.Google ScholarPubMed
Tri, T. B. & Coombs, D. T. (1975) Phenothiazine-induccd ventricular tachycardia. Western Journal of Medicine, 123, 412–6.Google ScholarPubMed
Werner, S. C. & Ingbar, S. H. eds. (1978) The Thyroid: 4th edition. New York: Harper and Row.Google ScholarPubMed
Whybrow, P. C., Prange, A. J. & Treadway, C. R. (1969) Mental changes accompanying thyroid gland dysfunction. Archives of General Psychiatry, 20, 43–63.CrossRefGoogle ScholarPubMed
Whybrow, P. C. & Ferrell, R. (1974) Chapter 1, Thyroid state and human behaviour. In The Thyroid Axis, Drugs and Behaviour, ed. A. J. Prange New York: Raven Press.Google Scholar
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