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        Thyroid Hormone Augmentation in Treatment-Refractory Depression

        Gabriela V Obrocea,Richard A Margolin,Tai P Yoo 대한정신약물학회 2008 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.6 No.1

        Objective:Partial response or no response to a single antidepressant trial is not uncommon in the pharmacotherapy of depressive disorders, and resistance to even aggressive treatment regimens, known as treatment-refractory depression (TRD), is an important clinical problem. The additive value of thyroid hormones in this context has been explored over many years, but their utility remains uncertain. The purpose of this paper is therefore to clarify the potential role of thyroid augmentation in treatment-refractory depression, in the light of contemporary pathophysiologic knowledge and the utility of other approaches. Methods:A literature search on thyroid augmentation studies in depression, including TRD, was conducted, using MEDLINE (National Library of Medicine), accessed via the PubMed portal. Results:The review examined the published literature from 1996 to 2005. Several randomized studies and a larger number of uncontrolled investigations which used both Triiodothyronine (T3) and Levothyroxine (T4) in the treatment of affective disorders were identified. Conclusion:The review supports the use of T4 and T3 in TRD, particularly in women suffering from depression and in bipolar depression. While, there is evidence linking thyroid function to affective disorders, the putative mechanisms underlying the action of these hormones in depression suggest promising directions for future research on thyroid treatments for TRD.

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