Decreased thyroid function in Korean women with bipolar disorder receiving valproic acid

We report here two adult female patients with bipolar disorder who developed abnormal thyroid function after short-or long-term administration of valproic acid (VPA). The first patient developed sick euthyroid syndrome (relative to her pretreatment thyroid levels) after only 2 months of treatment with VPA and quetiapine. The second patient, who had no pretreatment medical history including thyroid disease, developed hypothyroidism after several years of treatment with VPA and quetiapine.