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Notes:
- The addition of
small doses (25 to 50 mg) of thyroid hormone, triiodothyronine (T3),
has been used to augment response to TCAs, MAOIs, and SSRIs. Thase,
1995:1088 (2)
- T3 is thought
to potentiate effects on noradrenergic receptor sensitivity, increase
efficiency of noradrenergic neurotransmission, and correct subtle thyroid
abnormalities. Thase, 1995:1088 (2)
- Although T4
is a precursor of T3, T4 is less effective as an augmenting agent.
Joffe, 1990:241(Abstr)
- Fewer controlled
studies have been conducted than with lithium. T3 augmentation of TCAs
was shown to be effective in approximately 50% to 60% of patients. Joffe,
1996:27 (2)
- Conclusions
drawn from these studies have been interpreted cautiously, however,
as the studies suffered such methodologic flaws as small sample
size, inadequate dose and duration of TCA before T3 addition, and
uncontrolled study design. Joffe, 1996:27 (2)
- Although T3
augmentation is used less commonly than lithium augmentation, one
study has shown T3 is as effective as lithium, and both are more
effective than placebo in patients who have failed an adequate trial
of desipramine or imipramine. Joffe, 1993:387 (abstr)
- The efficacy of
T3 augmentation of MAOIs and the SSRI fluoxetine has been limited to
evaluation of case reports, but preliminary evidence suggests that T3
may be effective with a wide range of antidepressants. Joffe, 1992:48
(1,2)
- Improvement with
T3 usually occurs within 2 to 3 weeks, and should be discontinued thereafter.
- Monitoring
thyroid function after discontinuation of T3 is important because
endogenous thyroid hormone production may cease, indefinitely in
some cases. Bridges, 1995:504 (7)
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