Symptoms And Treatment Of Adolescent Disorders

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Psychiatry has utilized lithium to treat affective disorders since the late 1940s; however, roughly 30 years passed until its effect on the thyroid gland was observed.1 Lithium-induced hypothyroidism is a common consequence of lithium usage2 with an estimated prevalence rate between 6 and 52%.3 However, lithium-induced hyperthyroidism (LIH) is rare and infrequently reported in literature,1,2,4,5 with an incidence of <0.1%.5, 6 LIH usually occurs with long-term lithium treatment and typically presents as a painless and transient thyroiditis with proposed causality directed towards lithium’s toxic effect on the thyroid or a diffuse/toxic multinodular goiter.1, 5, 7 Autoimmunity and autoantibody production may be another culprit in the development of LIH, which has been demonstrated in 20% of lithium treated patients compared to 7.5% untreated.5, 8 Lithium and antipsychotics are often prescribed concomitantly in clinical practice. While LIH is a rare occurrence, antipsychotic-induced akathisia is more prevalent with an incidence rate of up to 30% reported.9 Akathisia is a movement disorder typically characterized by an inability to sit still and/or inner restlessness, which includes rocking, pacing, and fidgeting.10, 11 The distress and subjective feelings of akathisia may be mistaken as symptoms of a patient’s psychiatric disorder. Frequently, psychosis may appear more evident during akathisia due to increased agitation.12 Psychiatric manifestations have also been
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