Posted by jrbecker on June 26, 2003, at 20:00:31
http://www.medscape.com/viewarticle/457612
June 26, 2003
Triiodothyronine [T3] Does Not Improve SSRI Therapy for Major Depression
By Megan Rauscher
NEW YORK (Reuters Health) Jun 20 - The thyroid hormone triiodothyronine (T3) does not increase the efficacy of selective serotonin reuptake inhibitor (SSRI) therapy in patients with major depressive disorder, despite current recommendations.
That's according to results of a randomized, placebo-controlled trial reported this week at ENDO 2003, the 85th annual meeting of The Endocrine Society in Philadelphia.
"There is some controversy about whether or not it is useful to use T3 in addition to standard antidepressant treatment with SSRI or tricyclic antidepressants in the treatment of depression," study leader Dr. Eric Fliers of the University of Amsterdam, the Netherlands told Reuters Health.
In patients resistant to standard antidepressant therapy, the American Psychiatric Association suggests that T3 may enhance the therapeutic effects of antidepressants, he added.
Dr. Fliers and colleagues randomized 113 patients with major depression to T3 (25 g or 50 g) or placebo in addition to treatment with the SSRI paroxetine 30 mg daily.
In analyses based on 106 patients, T3 did not enhance or accelerate the response of patients to paroxetine, Dr. Fliers said. After 8 weeks, the response rate was 46% irrespective of randomization. The remission rate also did not differ significantly between the arms, at 32% in the two T3 arms and 36% in the placebo arm.
Moreover, patients treated with T3 reported significantly more side effects than patients treated with placebo.
"To be honest, we had expected to see increased efficacy but this is really the first randomized clinical trial on this issue," Dr. Fliers said. "Most studies have been nonrandomized or have examined the effects of T3 in addition to tricyclic antidepressants whereas nowadays most psychiatrists favor SSRIs."
Dr. Fliers believes this study may prompt a second look at recommendations on T3 use in depression.
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