Q. My 15yo son has been diagnosed BP1 with rapid cycling and Adhd. He is currently on 200 mg Wellbutrin, 1850mg of Depakote, 1350mg Eskalith CR and 10mg of Zyprexa. ( he is 6'3" and 240 lbs) He is complaining of fatigue, lethargy, inability to concentrate, feels sad ,angry and has suicidal ideation.( his Dr is aware of all of the above) I recently had his blood work drawn, everything was within normal limits except his thyroid, I was told it indicated he had sub clinical hypothyroidism. My question is would a small dose of a thyroid replacement medication added to his current regimen help alleviate his depression? and is sub clinical hypothyroidism a common finding in pts on lithium?

  A. Low thyroid levels frequently occur in folks taking lithium. It makes sense to increase the thyroid to normal levels. If he is already in the normal range, it probably will not make a difference in energy or depression, but may be worth a try. Talk it over with your doctor and see why they have not yet added thyroid. Follow his or her advice.