Treatment of Intractable Rapid-Cycling Manic-Depressive Disorder With Levothyroxine

Hypermetabolic doses of levothyroxine sodium produced remissions in five of seven women with intractable manic-depressive illness who were followed up for nine months to nine years. These patients had previously required long-term or frequent psychiatric hospitalization. The onset of illness was during the postpartum or involutional period and soon developed into cycles of four or more episodes yearly that did not respond to therapy with lithium carbonate, antidepressants, or neuroleptics. The levothyroxine treatment was unsuccessful in two men and one adolescent girl.