Thyroid Meds & Schizoaffective Disorder : Thyroid Meds & Losing Weight
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Q:  Thyroid Meds & Schizoaffective Disorder : Thyroid Meds & Losing Weight

Dear Dr. Phelps,

My daughter was diagnosed with bi-polar II in high school. By the age of 21 she had multiple hospitalizations and was diagnosed with schizoaffective disorder. During that time she also had a large lymph node that eventually was biopsied. An infectious disease specialist diagnosed it as chromatocytosis (spelling ?) [corrected in a subsequent letter to sarcoidosis -- JP], an autoimmune disorder!  I read the article on thyroid medications in the treatment of bi-polar disease...(in one of your archived answers). Do you think adding thyroid meds to her current meds would help with schizoafftive disorder? In addition, one of her meds was Zyprexa, for nearly a year, and subsequently she is morbidly obese. Can taking thyroid meds help her to take off some of that weight?


Dear Ms. K' -- 
Maybe and maybe.  Multiple general medical doctors whom I've asked on this have confirmed my impression that a trial of thyroid, short of doses that lead to hyperthyroidism, carries very little risk.  You'll see one risk, that of making symptoms worse as occurred in at least one of my patients, in the essay on
Thyroid and Bipolar Disorder, which you may already have visited.  As you may have learned, thyroid treatment has already been established as a "mood stabilizer" add-on, by the Whybrow research group.  So a trial of thyroid even at much higher doses than I've generally used is "okay" from the point of view of following established research. 

Not so established, but pretty tempting when you look at the logic of it, is a trial of metformin (glucophage).  You can find the rationale on that in the essay on Metabolic Syndrome, and the metformin page in case you miss the link in that essay.  Here are some general thoughts about weight gain and bipolar disorder.  You can see these paths lead to a strong consideration of Glucophage, but note that although we have tons of experience with this medication from its use in diabetes treatment, there is just slightly more than zero data on it (like a mere whiff...) in bipolar disorder.  

So, thyroid and just maybe glucophage could be considered for your daughter, but may I once more stress that the Glucophage idea is brand new, and the only reason I mention it here is because of the specific history you relate, which I think raises the odds that it might be of value.  

Dr. Phelps

Published March, 2003


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