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Our objective was to compare hypothyroidism risk for lithium versus the anticonvulsants and second\u2010generation antipsychotics commonly prescribed for <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Administrative claims data on 24,574 patients with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> were analyzed with competing risk survival analysis. Inclusion criteria were (i) one\u00a0year of no prior hypothyroid diagnosis nor <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> drug treatment, (ii) followed by at least one thyroid test during <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> monotherapy on lithium carbonate, mood\u2010stabilizing anticonvulsants (lamotrigine, valproate, oxcarbazepine, or carbamazepine) or antipsychotics (aripiprazole, olanzapine, risperidone, or quetiapine). The outcome was cumulative incidence of hypothyroidism per drug, in the presence of the competing risk of ending monotherapy, adjusted for age, sex, physician visits, and thyroid tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adjusting for covariates, the four\u2010year cumulative risk of hypothyroidism for lithium (8.8%) was 1.39\u2010fold that of the lowest risk therapy, oxcarbazepine (6.3%). Lithium was non\u2010statistically significantly different from quetiapine. While lithium conferred a higher risk when compared to all other treatments combined as a group, hypothyroidism risk error bars overlapped for all drugs. Treatment (p\u00a0=\u00a03.86e\u20103), age (p\u00a0=\u00a06.91e\u201010), sex (p\u00a0=\u00a03.93e\u20107), and thyroid testing (p\u00a0=\u00a02.79e\u201087) affected risk. Patients taking lithium were tested for hypothyroidism 2.26\u20133.05 times more frequently than those on other treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thyroid abnormalities occur frequently in patients with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> regardless of treatment. Therefore, patients should be regularly tested for clinical or subclinical thyroid abnormalities on all therapies and treated as indicated to prevent adverse effects of hormone imbalances on mood.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12391","type":"journal-article","created":{"date-parts":[[2016,5,26]],"date-time":"2016-05-26T13:16:38Z","timestamp":1464268598000},"page":"247-260","source":"Crossref","is-referenced-by-count":38,"title":["Hypothyroidism risk compared among nine common bipolar disorder therapies in a large <scp>US<\/scp> cohort"],"prefix":"10.1111","volume":"18","author":[{"given":"Christophe G","family":"Lambert","sequence":"first","affiliation":[{"name":"Center for Global Health Department of Internal Medicine University of New Mexico Health Sciences Center Albuquerque NM USA"},{"name":"Division of Translational Informatics Department of Internal Medicine University of New Mexico Health Sciences Center Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aur\u00e9lien J","family":"Mazurie","sequence":"additional","affiliation":[{"name":"Bioinformatics Core Montana State University Bozeman MT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas R","family":"Lauve","sequence":"additional","affiliation":[{"name":"Department of Computer Science University of New Mexico Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathaniel G","family":"Hurwitz","sequence":"additional","affiliation":[{"name":"New Mexico Behavioral Health Institute Las Vegas NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S Stanley","family":"Young","sequence":"additional","affiliation":[{"name":"CGStat, LLC Raleigh NC USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert L","family":"Obenchain","sequence":"additional","affiliation":[{"name":"Risk Benefit Statistics, LLC Bella Vista CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas W","family":"Hengartner","sequence":"additional","affiliation":[{"name":"Los Alamos National Laboratory Los Alamos NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas J","family":"Perkins","sequence":"additional","affiliation":[{"name":"Center for Global Health Department of Internal Medicine University of New Mexico Health Sciences Center Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauricio","family":"Tohen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences University of New Mexico Health Sciences Center Albuquerque NM USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berit","family":"Kerner","sequence":"additional","affiliation":[{"name":"Semel Institute for Neuroscience and Human Behavior David Geffen School of Medicine University of California Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,5,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders (DSM\u20105\u00ae)[Internet].American Psychiatric Pub 2013. 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