Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature

L. L. Altshuler, M. Bauer, M. A. Frye, M. J. Gitlin, J. Mintz, M. P. Szuba, K. L. Leight, P. C. Whybrow

Research output: Contribution to journalArticlepeer-review

187 Scopus citations

Abstract

Objective: The delayed onset of therapeutic response to antidepressants remains a major problem in the treatment of depression. Among the strategies to accelerate response to treatment, the early addition of thyroid hormone to antidepressants has been suggested as a viable method. The authors performed a meta-analysis of the literature on the use of thyroid hormone supplementation to accelerate the treatment of depression to determine whether there is sufficient evidence to support the clinical efficacy of this strategy. Method: Both a computer-aided search of the National Library of Medicine MEDLINE and an intensive search by hand were conducted to identify all double-blind, placebo-controlled studies assessing the concomitant administration of thyroid hormone and antidepressant to accelerate clinical response in patients with nonrefractory depression. Results: Six studies were identified. All were conducted with triiodothyronine (T3) and a tricyclic antidepressant. Five of the six studies found T3 to be significantly more effective than placebo in accelerating clinical response. The pooled, weighted effect size index was 0.58, and the average effect was highly significant. Further, the effects of T3 acceleration were greater as the percentage of women participating in the study increased. Conclusions: This meta-analysis supports the efficacy of T3 in accelerating clinical response to tricyclic antidepressants in patients with nonrefractory depression. Furthermore, women may be more likely than men to benefit from this intervention.

Original languageEnglish (US)
Pages (from-to)1617-1622
Number of pages6
JournalAmerican Journal of Psychiatry
Volume158
Issue number10
DOIs
StatePublished - 2001

ASJC Scopus subject areas

  • Psychiatry and Mental health

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