Thyroid Hormones as a Third Line of Augmentation Medication in Treatment-Resistant Depression

Trifu, Simona; Popescu, Alexandra; Drăgoi, Ana Miruna; Trifu, Antonia Ioana

doi:10.4183/aeb.2020.256

Cited by 13 publications

(9 citation statements)

References 17 publications

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“…Overt hypothyroidism and SCH are common concomitant illnesses associated with MDD, particularly in women [ 23 ]. Treatment-resistant MDD, increased severity of MDD, psychotic phenomenology, and somatic symptoms are all possible consequences of this comorbidity [ 24 ]. Patients with MDD may have immune system activation, which can develop into autoimmune thyroiditis and thyroid dysfunction [ 25 ].…”

Section: Reviewmentioning

confidence: 99%

“…Patients with MDD may have immune system activation, which can develop into autoimmune thyroiditis and thyroid dysfunction [ 25 ]. Thyroid hormone replacement therapy has been shown to benefit individuals with hypothyroidism and MDD, particularly treatment-resistant patients or/and those with unusual symptoms [ 24 ]. Overt hypothyroidism, on the other hand, is associated with effective and broader neuropsychiatric symptomatology [ 26 ].…”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Hypothyroidism and Depression: A Narrative Review

Nuguru¹,

Rachakonda²,

Sripathi³

et al. 2022

Cureus

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There has been an established relationship between hypothyroidism and depression. Studies have demonstrated that somatostatin and serotonin influence the hypothalamus-pituitary-thyroid axis, which links hypothyroidism to depression. Multiple studies concluded that undiagnosed, untreated, undertreated patients with hypothyroidism are at increased risk of developing depression. Autoimmune thyroiditis is also associated with an increased risk of depression. Elevated thyroid-stimulating hormone (TSH), antithyroglobulin (TgAb), and thyroid peroxidase antibodies (TPOAb) levels have all been linked to depression and an increased risk of suicide. Moreover, hypothyroidism is known to be one of the leading causes of treatment-resistant depression. Treating underlying hypothyroidism with thyroid replacement therapy could significantly improve mood disorders such as depression. Levothyroxine therapy is also used as adjunctive therapy to antidepressants in the management of depression, and it is known to improve the symptoms of depression rapidly when compared to antidepressants alone. This review strengthens the link between hypothyroidism and depression, and it also demonstrates how treating the underlying hypothyroidism in people who have been diagnosed with depression will be very beneficial.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Hypothyroidism and Depression: A Narrative Review

Nuguru¹,

Rachakonda²,

Sripathi³

et al. 2022

Cureus

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“…En un estudio de revisión realizado en Honduras, se encontró que, aunque usualmente los pacientes cursan asintomáticos, existen complicaciones cardiovasculares, propiamente del miocardiocito y en la angiogénesis coronaria arteriolar, dando lugar a cuadros como insuficiencia cardiaca congestiva, al igual que dislipidemias, trastornos de la coagulación e hipertensión arterial asociada predominantemente diastólica, encontrando complicaciones hasta en un 80%, lo que contrasta con el 64.3% de nuestra población estudiada IC95% (21). Igualmente, se ha encontrado que la levotiroxina tiene utilidad en las pacientes femeninas, así como, un mayor número de pacientes femeninas afectadas con forme aumenta la edad, relacionándolo a genes como DIO1 y FT4, IC95%, mismo que se relaciona con el mayor número de pacientes femeninas en nuestro estudio con forme aumenta la edad (22). Con respecto a la tensión arterial y los efectos cardiovasculares, encontramos en nuestro estudio, por medio del valor de Fisher, un riesgo aumentado de presentar mayores complicaciones con respecto a la media estudiada en otro protocolo realizado por el national health and nutrition examination survey; se estudiaron mediante análisis de percentiles, para estimar los riesgos, encontrándose aumento en todas las causas asociadas a hipotiroidismo IC95%, coincidiendo con los resultado obtenidos (23).…”

Section: Discussionunclassified

Incidencia de síndrome metabólico en pacientes con hipotiroidismo subclínico, Enero 2019 Julio 2022 en Ciudad Juárez

Alcaraz

Lares

2023

Rev.méd.sinerg.

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Introducción: El hipotiroidismo subclínico, al igual que el síndrome metabólico, se consideran importantes patologías para la práctica médica. El primero se trata de una disfunción orgánica de la glándula tiroidea; y el otro, por su parte, una resistencia a la insulina y el estrés oxidativo. En conjunto, se asocian con importantes comorbilidades en el paciente, lo que afecta su calidad de vida. Métodos: En un total de 1402 consultas, entre 2019 y 2022, se estudiaron 582 pacientes, obteniendo un total de 161 pacientes para la muestra estadística. Evaluándolos con los criterios de las ultimas guías BMJ y ATA, estudiando la incidencia de síndrome metabólico a través de los parámetros clínicos y bioquímicos. Resultados: Se distribuyó en dos grupos y dos subgrupos respectivamente, mostrando mayor incidencia de pacientes con síndrome metabólico, en comparación con la población general. La media de edad fue (42 ± 12.519), el grupo 2 (42.16 ± 12.875), sin observarse diferencias estadísticas (t=.119 y t=.266). Presentan una correlación (Rho spearman1=.108) y (Rho spearman2=-.90). Un IMC (31.62 ± 7.96 kg/m2), el grupo 2 (32.76 ± 6.59 kg/m2). En pacientes en tratamiento se analizó prueba exacta de Fisher (f1= .355 y f2=.878) y un (RR de 1.97) sobre el riesgo de comorbilidades en comparación con la población (p > 0.0001). Conclusión: En la población, existe una importante asociación entre estas patologías y otras comorbilidades, reflejando la elevada prevalencia de obesidad, diabetes e hipertensión arterial en cara a la condición actual de nuestro país, explicando así la importancia de encontrar terapias efectivas y adaptables a nuestra comunidad.

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“…(6) thyroxine and TRH are used successfully for treatment of major depression [ 28 ]. However, some recent studies and reviews showed controversial evidence [ 29 ]. (7) the occurrence of stress may play a role in evocation of psychiatric symptoms in genetically vulnerable patients with thyrotoxicosis [ 20 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, some recent studies and reviews showed controversial evidence [ 29 ]. (7) the occurrence of stress may play a role in evocation of psychiatric symptoms in genetically vulnerable patients with thyrotoxicosis [ 20 , 28 , 29 ]. In accordance, Morillo and Gardner [ 28 ] reported that the onset of relapse of GD in four children (8–14 years) (HLA B-8) was induced by depression as a common response to loss.…”

Section: Discussionmentioning

confidence: 99%

Behavioral assessment of children and adolescents with Graves’ disease: A prospective study

et al. 2021

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Previous studies have identified frequent comorbid neuropsychiatric disorders and conditions in adults with thyrotoxicosis. These studies are scarce or even lacking in pediatric population. This work aimed to study the behavior of children and adolescents with Graves’ disease (GD). This study included 35 children with GD (boys = 15; girls = 25; mean age: 11.45±1.50yrs) and 40 healthy children (boys = 20; girls = 20; mean age: 12.54±1.62yrs). Behavior was assessed using Child Behavior Checklist (CBCL). Children with GD were assessed during periods of thyroid hormone elevation (active disease) and normalized thyroid hormones (with anti-thyroid drugs or ATDs). Compared to healthy children, patients during periods of thyroid hormone elevation (74.29%) and normalized thyroid hormones (31.43%) had higher frequencies of behavioral abnormalities and scorings of total CBCL scale (P = 0.01; P = 0.04, respectively) and its subscales’ [Anxious/Depressed (P = 0.02; P = 0.04), Withdrawn/Depressed (P = 0.03; P = 0.04) and Somatic Complaints (P = 0.03; P = 0.127) and Social (P = 0.01; P = 0.225), Thought (P = 0.01; P = 0.128) and Attention (P = 0.01; P = 0.01) problems], indicating internalizing and externalizing problems. The majority of patients had at least two different behavioral problems. Marked improvement was found during period of normalized thyroid hormones (P = 0.001). Correlation analyses showed significant associations between total CBCL scoring and age at onset (P = 0.01; P = 0.001) and lower concentrations of thyroid stimulating hormone (TSH) (P = 0.001; P = 0.04) and higher concentrations of free thyroxine (fT4) (P = 0.01; P = 0.02), triiodothyronine (fT3) (P = 0.01; P = 0.03) and thyrotropin receptor antibodies (TRAbs) (P = 0.001; P = 0.01) during periods of thyroid hormone elevation and normalized thyroid hormones, respectively. Multiple linear regression analysis showed that "at presentation" lower concentrations of TSH (P = 0.001; P = 0.03) and higher concentrations of fT4 (P = 0.001, P = 0.01), fT3 (P = 0.01; P = 0.06) and TRAbs (P = 0.001; P = 0.001) were predictors of behavioral problems during periods of active disease and normalized thyroid hormones. We conclude that GD is associated with higher frequencies and severities of anxiety, depression and inattention during periods of thyroid hormone elevation as well as normalized thyroid hormones with ATDs. Therefore, early diagnosis and optimizing management are required to improve children’s social life.

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Thyroid Hormones as a Third Line of Augmentation Medication in Treatment-Resistant Depression

Cited by 13 publications

References 17 publications

Hypothyroidism and Depression: A Narrative Review

Hypothyroidism and Depression: A Narrative Review

Incidencia de síndrome metabólico en pacientes con hipotiroidismo subclínico, Enero 2019 Julio 2022 en Ciudad Juárez

Behavioral assessment of children and adolescents with Graves’ disease: A prospective study

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