resistant depression

Q: Which of the following drug has shown efficacy as an adjuvant treatment in resistant depression?

A) Thyroid replacements
B) Corticosteroids
C) Growth hormone
D) Estrogen replacements
E) Testosterone replacements


Answer: A

The exact mechanism is not cleared but this is proposed that antidepressants may have iatrogenic effects on the thyroid. Antidepressants may induce a change in iodine capture by thyroid cells or can make it unavailable for thyroid hormone synthesis. T3 is preferred over T4.

#psychiatry
#endocrinology



References:

 1. Nierenberg AA, Fava M, Trivedi MH, et al. A comparison of lithium and T(3) augmentation following two failed medication treatments for depression: a STAR*D report. Am J Psychiatry 2006; 163:1519.

2. Joffe RT, Singer W. A comparison of triiodothyronine and thyroxine in the potentiation of tricyclic antidepressants. Psychiatry Res 1990; 32:241.

3. Cooper-Kazaz R, Lerer B. Efficacy and safety of triiodothyronine supplementation in patients with major depressive disorder treated with specific serotonin reuptake inhibitors. Int J Neuropsychopharmacol 2008; 11:685.

4. Shelton RC, Osuntokun O, Heinloth AN, Corya SA. Therapeutic options for treatment-resistant depression. CNS Drugs 2010; 24:131.

5.  Sauvage MF, Marquet P, Rousseau A, Raby C, Buxeraud J, Lachâtre G. Relationship between psychotropic drugs and thyroid function: a review. Toxicol Appl Pharmacol. 1998 Apr;149(2):127-35.