ABSTRACT
Substitution of T4 with T3 for T4 replacement in patients with hypothyroidism was undertaken using a randomized placebo controlled study design. Forty individuals were included who had depressive symptoms on stable doses of levothyroxine. Combined T4 plus T3 did not have a significantly different effect on mood and well-being scores than did T4 alone.
Subject(s)
Depressive Disorder/drug therapy , Depressive Disorder/psychology , Hypothyroidism/drug therapy , Hypothyroidism/psychology , Thyroxine/therapeutic use , Triiodothyronine/therapeutic use , Adult , Aged , Depressive Disorder/etiology , Drug Therapy, Combination , Female , Hormone Replacement Therapy , Humans , Hypothyroidism/complications , Male , Middle Aged , Psychiatric Status Rating Scales , Thyrotropin/bloodABSTRACT
Current series of depression suggests that episodes of major depression sensitize a patient to further episodes so that the illness adopts a recurrent course. This suggested pathophysiological process may also lead to increased risk of treatment resistance and a chronic course of illness. This hypothesis has received little empirical support and, if correct, would suggest that greater number of episodes would lead to a decreased response to antidepressants. We examined this in a cohort of outpatients with major depressive disorder. We observed that initial severity of depression and duration of treatment, but not number of previous episodes, was related to treatment outcome. Our findings are discussed in relation to prevailing theories of the pathophysiology of depression and suggestions for further studies are made.
