Mom Has Questions Re: BP,Thyroid,OCD, Zyprexa
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Q:  Mom Has Questions Re: BP, Thyroid, OCD, Zyprexa

My son has been diagnosed with bipolar disorder. I have been researching this disorder to see if that is what I believe he has. I have read that if thyroid problems exist on the mother's side, there is a connection to a genetic inheritance to bypolar. Thyroid problems are very existant in my family. I have underactive thyroid, along with my mother, father, brother, and my sister and neice have overactive thyroid. Could this possibly explain my son having bypolar disorder? Also, could bipolar disorder cause obsessive, compulsive disorder? He has times of high stress when he has symptoms of obsessive, compulsive disorder. THe doctor is prescribing zyphrexia.(spelling?) Does this medicine seem to be helping with bipolar and obsessive, compulsive disorder, both? Thank you for answering my questions, I just want my son to be receiving the best help he can get.

Dear Sue -- 
Taking your questions one at at time: 
1. Yes, there is some connection between bipolar disorder and thyroid disorders.  To my knowledge, the nature of the connection is not known; rather, what we know so far is that there are a lot more associations than one would expect otherwise -- people with bipolar having thyroid abnormalities, and families with thyroid abnormalities having bipolar disorder.  Therefore, I don't think we can quite say that the thyroid abnormalities in your family "explain" your son's bipolar disorder, but there does indeed seem to be a relationship and indeed it's worth watching is thyroid functions closely.  For example, there is evidence that if TSH is above about 2, response to attempts to treat bipolar depression will be less strong in many people, so it's worth making sure that TSH stays around 1.0.  And as you've probably read, there are "mood stabilizer" treatment approaches using thyroid hormone.  More on this, if you haven't already been there, in my little essay on thyroid and bipolar disorder.  I will be adding more there as this story unfolds. 

2. Can BP cause OCD symptoms?  Yes, in my view.  I've had quite a few patients who seem to have both, but in many cases the "OCD" symptoms got better when the BP symptoms got better, without a serotonergic antidepressant. 

3. Zyprexa: will it help?  Might get all his symptoms, or only part of them, reasonable choice except watch out for weight gain and ask the doc' to have a alternative plan to consider if weight is clearly going up (it does in a very large number of patients taking this medication, and it can go way up, 10-15 kg very quickly. 

Dr. Phelps


Published May, 2002 

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