Baumgartner A, von Stuckrad M, Müller-Oerlinghausen B, Gräf K J, Kürten I
Department of Psychiatry, Klinikum Rudolf Virchow (Charlottenburg), Free University of Berlin, Germany.
J Affect Disord. 1995 Jun 8;34(3):211-8. doi: 10.1016/0165-0327(95)00019-j.
Serum concentrations of thyrotropine (TSH), thyroxine (T4), free T4 (fT4), triiodothyronine (T3) and reverse T3 (rT3) were measured 4 x during a 12-month period in 28 patients with major depressive disorder maintained on lithium prophylaxis for 4-23 years (mean = 11.8). The course of illness was carefully monitored and documented for all patients throughout a 3.5-year period. All hormones were also measured in 41 healthy controls matched for age and gender. Patients on lithium had normal serum concentrations of TSH, T4, fT4 and T3 only the levels of rT3 were elevated. The efficacy of the lithium prophylaxis was significantly correlated to the serum concentrations of T3, i.e., the higher the patients' serum levels of T3, the shorter was the overall duration of recurrences of depression within the 3.5-year period. We conclude that: (1) thyrotropine and the thyroid hormones, which are often abnormal during the first weeks or months of lithium treatment, returned to normal when lithium prophylaxis was maintained for years; (2) a possible explanation for the higher T3-serum concentrations in responders might be that lithium interacts with thyroid hormone metabolism in the CNS, leading to enhanced T3 concentrations in the tissue and to a secondary increase in the serum concentrations of T3.
在12个月内对28例维持锂盐预防性治疗4至23年（平均11.8年）的重度抑郁症患者的促甲状腺激素（TSH）、甲状腺素（T4）、游离T4（fT4）、三碘甲状腺原氨酸（T3）和反三碘甲状腺原氨酸（rT3）的血清浓度进行了4次测量。在3.5年期间对所有患者的病程进行了仔细监测和记录。还对41名年龄和性别匹配的健康对照者进行了所有激素的测量。服用锂盐的患者TSH、T4、fT4和T3的血清浓度正常，只有rT3水平升高。锂盐预防性治疗的疗效与T3的血清浓度显著相关，即患者血清T3水平越高，3.5年内抑郁症复发的总持续时间越短。我们得出以下结论：（1）在锂盐治疗的最初几周或几个月内经常异常的促甲状腺激素和甲状腺激素，在维持锂盐预防性治疗数年时恢复正常；（2）反应者中T3血清浓度较高的一个可能解释是锂盐与中枢神经系统中的甲状腺激素代谢相互作用，导致组织中T3浓度升高，继而血清T3浓度继发性升高。
