The effects of antidepressants on the thyroid axis in depression
Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN. Biological Psychiatry
(Impact Factor: 10.26).
02/1993; 33(2):120-6. DOI: 10.1016/0006-3223(93)90311-Z
Thirty-nine patients with major depression were studied to determine the differential effects of desipramine (DMI) and fluoxetine (FLU) on thyroid hormones. Twenty-six percent showed some abnormality in baseline thyroid hormone levels. There were no demonstrable differences for any of the thyroid indices from baseline to the 3- or 6-week samples for the total group or for either drug by repeated measures analysis of variance. There was a significant group by time interaction for total thyroxine (TT4) between the drug treatment groups, which was caused by a small but significant increase in TT4 in the DMI sample. Correlations were performed between the change in hormones over the 6 week period and treatment response. There was a significant association between a decline in triiodothyronine (T3) levels and response to FLU but not DMI. The implications of these findings for the pathophysiology of depression and antidepressant drug mechanisms are discussed.
Available from: Jacques Bradwejn
- "The observed changes after treatment with amitriptyline may be specific to tricyclic antidepressants but unrelated to the effects on the serotonergic system. Shelton et al (1993) reported that desipramine, but not fluoxetine, was associated with an increase in total T4 during treatment for depression. The mechanism by which antidepressants decreased T4 and ff4 levels during treatment is still unknown and deserves further research. "
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ABSTRACT: Thirty-nine unipolar depressed patients were treated, after a washout period of seven days in a double blind study with either moclobemide, placebo or amitriptyline, for 42 days. The psychopathological assessment and HRSD were done on seven day intervals and thyroid analysis was done on 14 day intervals. At the end of therapy, the levels of T4 and fT4 decreased significantly in the responders if amitriptyline was used, and non-significantly if placebo or moclobemide were used. The T4 and fT4 values of the non-responders increased non-significantly. The weight change was minimal and non-significant.
Available from: Michael Maes
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ABSTRACT: The present study was carried out to investigate the relationship between basal hypothalamic— pituitary—thyroid (HPT)-axis function and the acute phase (AP) response in depression. Toward this end, the authors measured serum concentrations of basal thyroid-stimulating-hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3), and plasma levels of an AP protein, i.e. haptoglobin (Hp) in 38 depressed in-patients and in 11 normal controls. In depression, basal TSH was significantly and negatively related to Hp values, whereas in normal controls a trend toward a positive correlation between both factors was found. Depressed patients with increased Hp levels (≥250 mg/dl) showed significantly lower basal TSH levels than patients with normal Hp levels. No significant correlations were found between Hp plasma levels and either FT4 or FT3 serum concentrations. The results support the hypothesis that lower TSH secretion in major depression may be related to the AP response in that illness, and may constitute an expression of a coordinated neuroendocrine-immune response to nonthyroidal illness.
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