Preventive Effect of Liothyronine on Electroconvulsive Therapy-Induced Memory Deficit in Patients with Major Depressive Disorder: A Double-Blind Controlled Clinical Trial

Mohagheghi, Arash; Arfaie, Asghar; Amiri, Shahrokh; Nouri, Masoud; Abdi, Salman; Safikhanlou, Salman

doi:10.1155/2015/503918

Cited by 10 publications

(5 citation statements)

References 15 publications

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“…The ADRs to LT3 were not considered a primary outcome in any of the studies and only five reported specifically on palpitation, heart rate, and tremor, with the remainder only mentioning nonspecific ADRs (Supplementary Table S3). Remarkably, in none of these 12 studies did the association of LT3 result in ADRs (131)(132)(133)(134)(135)(136)(137)(138)(139)(140)143,144). A subsequent meta-analysis that included eight studies (five clinical trials described earlier plus three observational studies) failed to identify differences in ADRs in LT3 versus control patients (145).…”

Section: Clinical Trials In Which Liothyronine Therapy Was Used In Euthyroid Individualsmentioning

confidence: 99%

“…The LT3 has been used in patients with major depressive disorder as an adjuvant to the conventional treatment with antidepressants, even if the patients are euthyroid (Supplementary Table S3) (131)(132)(133)(134)(135)(136)(137)(138)(139)(140)(141)(142)(143)(144). We identified 12 prospective clinical trials conducted between 1970s and 2018 (Supplementary Table S2) in which a regimen with LT3 was used.…”

Section: Clinical Trials In Which Liothyronine Therapy Was Used In Euthyroid Individualsmentioning

confidence: 99%

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Liothyronine and Desiccated Thyroid Extract in the Treatment of Hypothyroidism

Idrees

Palmer

Maciel

et al. 2020

Thyroid

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Background:The basis for the treatment of hypothyroidism with levothyroxine (LT4) is that humans activate T4 to triiodothyronine (T3). Thus, while normalizing serum thyrotropin (TSH), LT4 doses should also restore the body's reservoir of T3. However, there is evidence that T3 is not fully restored in LT4-treated patients. Summary: For patients who remain symptomatic on LT4 therapy, clinical guidelines recommend, on a trial basis, therapy with LT4+LT3. Reducing the LT4 dose by 25 mcg/day and adding 2.5-7.5 mcg liothyronine (LT3) once or twice a day is an appropriate starting point. Transient episodes of hypertriiodothyroninemia with these doses of LT4 and LT3 are unlikely to go above the reference range and have not been associated with adverse drug reactions. Trials following almost a 1000 patients for almost 1 year indicate that similar to LT4, therapy with LT4+LT3 can restore euthyroidism while maintaining a normal serum TSH. An observational study of 400 patients with a mean follow-up of *9 years did not indicate increased mortality or morbidity risk due to cardiovascular disease, atrial fibrillation, or fractures after adjusting for age when compared with patients taking only LT4. Desiccated thyroid extract (DTE) is a form of combination therapy in which the LT4/LT3 ratio is *4:1; the mean daily dose of DTE needed to normalize serum TSH contains *11 mcg T3, but some patients may require higher doses. The DTE remains outside formal FDA oversight, and consistency of T4 and T3 contents is monitored by the manufacturers only. Conclusions: Newly diagnosed hypothyroid patients should be treated with LT4. A trial of combination therapy with LT4+LT3 can be considered for those patients who have unambiguously not benefited from LT4.

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Section: Clinical Trials In Which Liothyronine Therapy Was Used In Euthyroid Individualsmentioning

confidence: 99%

Section: Clinical Trials In Which Liothyronine Therapy Was Used In Euthyroid Individualsmentioning

confidence: 99%

Liothyronine and Desiccated Thyroid Extract in the Treatment of Hypothyroidism

Idrees

Palmer

Maciel

et al. 2020

Thyroid

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“… 46 , 47 One trial supplied insufficient data for quantitative synthesis, but described a significantly positive effect on global cognitive outcome (see E‐Table 2 in the Supplement). 48 …”

Section: Resultsmentioning

confidence: 99%

“…Three studies did not meet criteria for inclusion in our quantitative synthesis; however, two of these were small crossover trials, which reported a statistically significant effect on cognitive outcome 46,47 . One trial supplied insufficient data for quantitative synthesis, but described a significantly positive effect on global cognitive outcome (see E‐Table in the Supplement) 48 …”

Section: Resultsmentioning

confidence: 99%

Pharmacological interventions to diminish cognitive side effects of electroconvulsive therapy: A systematic review and meta‐analysis

Verdijk

Kessel

Oud

et al. 2022

Acta Psychiatr Scand

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Objective The authors conducted a systematic review and meta‐analysis of pharmacological interventions to diminish cognitive side effects of ECT. Methods Electronic databases of Pubmed, PsycInfo, Embase and Scopus were searched from inception through 1 April, 2021, using terms for ECT (e.g. electroconvulsive therapy), cognitive outcome (e.g. cogni*) and pharmacological intervention (e.g. calcium channel blocker and general terms, like protein). Original studies with humans receiving ECT were included, which applied pharmacological interventions in comparison with placebo or no additive intervention to diminish cognitive side effects. Data quality was assessed using Risk of Bias and GRADE. Random‐effects models were used. PROSPERO registration number was CRD42021212773. Results Qualitative synthesis (systematic review) showed 52 studies reporting sixteen pharmacological intervention‐types. Quantitative synthesis (meta‐analysis) included 26 studies (1387 patients) describing twelve pharmacological intervention‐types. Low‐quality evidence of efficacy was established for memantine (large effect size) and liothyronine (medium effect size). Very low‐quality evidence shows effect of acetylcholine inhibitors, piracetam and melatonin in some cognitive domains. Evidence of no efficacy was revealed for ketamine (very low‐quality), herbal preparations with anti‐inflammatory properties (very low to low‐quality) and opioid receptor agonists (low‐quality). Conclusion Memantine and liothyronine are promising for further research and future application. Quality of evidence was low because of differences in ECT techniques, study populations and cognitive measurements. These findings provide a guide for rational choices of potential pharmacological intervention research targets to decrease the burden of cognitive side effects of ECT. Future research should be more uniform in design and attempt to clarify pathophysiological mechanisms of cognitive side effects of ECT.

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“…A recent review has reported that the relationship between the years of education, and the neurocognitive effects of ECT had not been investigated (McClintock et al, 2014), and our study has added relevant evidence. Liothyronine has been reported to reduce the memory deficits following ECT in people with depression, but the relationship between hypothyroidism and the memory deficits has not been studied (Mohagheghi et al, 2015).…”

Section: Discussionmentioning

confidence: 99%