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Re: hyperthyrodism and cyclothymia

Posted by SLS on December 13, 2000, at 20:23:27

In reply to hyperthyrodism and cyclothymia, posted by Jim R on December 13, 2000, at 2:41:39

> Hello, all. I have the whole gamut of irregular neurotransmitter symptoms and have for years, mostly at a sub-clinical level and all suggesting a mild bipolar condition of some kind: racing thoughts, occasional stuporous depression, sleep irregularities, anxiety, panic, dislike of bright lights, high creativity, etc. I don't really cycle, per se, but have very unstable moods, like a boat with no keel bobbing up and down through the day. The descriptions of ultra-rapid cycling seem to be the ones that fit me best. I have gotten so tired of all this that I am now trying to get some treatment.
>
> I am now taking gabapentin/neurontin (900mg/d), which seems to have brought the racing thoughts under control, but there is still very little over all stability and depression, anxiety, panic, etc. are all still present. Have been going through trials of celexa and serzone but had too many side effects with each.
>
> I want to investigate thyroid possibilities. I have read that hypOthyrodism is often connected with rapid cycling; but I seem clearly to have some symptoms of hypERthyrodism: including tremor, high startle response, somewhat bulging eyes, and perpetually inflamed eyelids (this is very distinctive; they are highly vascularized and red; have been for years). Once I had my thyroid checked in another context and some assistant said it was "normal" but I don't put much stock in that.
>
> I have read the many associations between hypOthyroid and the mood instability I seem to display. Can anyone tell me if hypERthyroidism can produce similar rapid cycling mood symptoms? (I'm not an M.D., but I am a biologist so will be glad to hear technical answers and references, as well as more general ones.)
>
> Many thanks.
>
> Jim R


I have no technical input regarding an association between thyroid state and cyclothymia. My gut tells me that hypERthyroidism is more likely to be responsible for rapid-cyclicity and hypOthyroidism for a stable atypical-type depression. I think it would be a good idea to pursue the thyroid issue further. I feel that it takes a good endocrinologist to accurately administer testing and evaluate the results. It is more complicated than simply assaying absolute levels of T3, T4, and TSH, and comparing them to the prescribed "normal" ranges. Noa, a frequent poster here, has focused quite a bit of her research into the contributions of thyroid function to mood-illness. You might find some useful information in her Psycho-Babble tips section:

http://www.egroups.com/links/psycho-babble-tips//Noa_s_thyroid_links_000963272558/


I would offer that you might look into adding Lamictal (lamotrigine), another anticonvulsant mood-stabilizer, to Neurontin. The NIMH has been reporting success with this combination as they seem to act synergistically. Currently, I believe Lamictal is generally considered to be more effective against rapid-cyclicity. It certainly possesses antidepressant properties on its own, seemingly independent of its mood-stabilizing properties. The two drugs are very compatible.

Also, 900mg is far from the upper limit of Neurontin dosage. I should think that the effective range usually lies between 1200mg and 1800mg.

Good luck.


- Scott

 

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