Posted by SLS on September 13, 2005, at 7:26:59
Hi.
I came across an article describing the use of T3 (triiodothyronine) thyroid hormone in combination with SSRI for treatment resistant depression. It seems that T3 will improve unipolar atypical depression, but make unipolar melancholic depression worse. Cytomel T3 made me much worse. However, my depression is bipolar. On the other hand T4 (thyroxine) helped me.
Perhaps the selection of which thyroid hormone to choose for augmentation of antidepressants should be determined by the subtype of depression being treated; T4 for melancholic unipolar and bipolar depression and T3 for atypical unipolar depression. One thing I would recommend based upon my own experience with thyroid hormones is that one cannot rule-out the usefulness of one type based upon the response to the other.
- Scott
1: J Clin Psychiatry. 2005 Aug;66(8):1038-42. Related Articles, Links
An open study of triiodothyronine augmentation of selective serotonin reuptake inhibitors in treatment-resistant major depressive disorder.Iosifescu DV, Nierenberg AA, Mischoulon D, Perlis RH, Papakostas GI, Ryan JL, Alpert JE, Fava M.
From the Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston.
OBJECTIVE: In an open trial, we investigated the efficacy of triiodothyronine (T(3)) adjuvant to selective serotonin reuptake inhibitors (SSRIs) in subjects with major depressive disorder (MDD) resistant to SSRI treatment. METHOD: Twenty subjects who met DSM-IV criteria for MDD (mean +/- SD age = 44.3 +/- 10.3 years; 55% [N = 11] women) and had failed to respond to a course of treatment of at least 8 weeks with an SSRI antidepressant were enrolled in a 4-week open-label augmentation treatment with T(3) 50 mug/day. Atypical and melancholic sub-types of MDD were diagnosed using Structured Clinical Interview for DSM-IV Axis I Disorders criteria. We administered the 17-item Hamilton Rating Scale for Depression (HAM-D-17) 4 times during the study (which was conducted between 2001 and 2003). RESULTS: During T(3) augmentation, the severity of depression decreased from an initial mean +/- SD HAM-D-17 score of 20.5 +/- 3.6 to a final HAM-D-17 score of 14.0 +/- 7.1 (p < .001). Seven subjects (35.0%) were treatment responders (HAM-D-17 reduction >/= 50%), and 6 subjects (30.0%) achieved clinical remission (final HAM-D-17 </= 7). The 5 subjects with atypical depression experienced significantly (p < .01) greater clinical improvement (final HAM-D-17 scores 6.6 +/- 1.8 vs. 16.4 +/- 4.5), and higher rates of treatment response (100% [5/5] vs. 13.3% [2/15]) and remission (80.0% [4/5] vs. 13.3% [2/15]), compared to subjects with nonatypical MDD. The 8 subjects with melancholic MDD experienced significantly (p < .05) greater depression severity at the end of the study compared to nonmelancholic MDD subjects (final HAM-D-17 scores = 18.3 +/- 6.6 vs. 11.1 +/- 6.1). CONCLUSION: Triiodothyronine augmentation of SSRIs may be a promising treatment strategy in SSRI-resistant MDD, particularly in subjects with the atypical MDD subtype.
PMID: 16086620 [PubMed - in process]
poster:SLS
thread:554549
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