Thyroid hormones affect recovery from depression during antidepressant treatment
Article first published online: 30 MAR 2009
© 2009 The Authors. Journal compilation © 2009 Japanese Society of Psychiatry and Neurology
Psychiatry and Clinical Neurosciences
Volume 63, Issue 3, pages 305–313, June 2009
How to Cite
Pae, C.-U., Mandelli, L., Han, C., Ham, B.-J., Masand, P. S., Patkar, A. A., Steffens, D. C., De Ronchi, D. and Serretti, A. (2009), Thyroid hormones affect recovery from depression during antidepressant treatment. Psychiatry and Clinical Neurosciences, 63: 305–313. doi: 10.1111/j.1440-1819.2009.01938.x
- Issue published online: 14 MAY 2009
- Article first published online: 30 MAR 2009
- Received 20 March 2008; revised 10 December 2008; accepted 16 December 2008.
- antidepressant treatment;
- thyroid hormone
Aims: The aim of the present study was to evaluate whether thyroid hormonal changes during menopause may affect the development and the course of major depressive disorder.
Methods: Thirty-nine female patients (n = 17 in pre-menopause; n = 22 in post-menopause) with major depressive disorder based on Diagnostic Statistical Manual of Mental Disorders (4th edition) criteria and who were euthyroid and not on hormonal replacement therapy, participated in a prospective, 6-week, open-label naturalistic study. The Hamilton Depression Rating Scale-17 item, the Montgomery-Åsberg Depression Rating Scale, the Clinical Global Impression scale and the Cognitive Failure Questionnaire were administered at baseline, week 1, week 3, and week 6. Levels of thyroid stimulating hormone, total thyroxine and total triiodothyronine were collected at baseline visit.
Results: In the whole sample, particularly in pre-menopausal women, levels of thyroid stimulating hormone-potential markers of subclinical hypothyroidism were correlated with those of less severe but more resistant depressive form. Conversely, total thyroxine levels were correlated with a more severe depression, but high levels of this hormone favored the response to antidepressants. Overall, a diagnosis of subclinical hypothyroidism was associated with a poor response to antidepressant treatment. Finally, total triiodothyronine levels were associated with better cognitive functioning, though they did not influence improvement occurring with recovery.
Conclusions: Our study suggests that thyroid hormones may have an impact on severity and efficacy of antidepressant treatment. However, our result should be considered with caution and merely as a suggestion due to some methodological limitations. Hence further studies are required to better ascertain the role of thyroid hormones in depression after menopause.