Randomised trial of thyroxine to prevent postnatal depression in thyroid-antibody-positive women.
BACKGROUND
Women who are positive for thyroid antibodies in early gestation are prone to post-partum depression, apparently independent of thyroid dysfunction, as measured by serum levels of free thyroxine, free triodothyroxine and thyroid-stimulating hormone. This finding may be due to infrequent monitoring of thyroid function, because hyperthyroidism, hypothyroidism and combinations of both may occur post-partum.


OBJECTIVE
To test the hypothesis that stabilising thyroid function post-partum by administering daily thyroxine reduces the rate of occurrence and severity of associated depression.


METHODS
In a randomised double-blind placebo-controlled trial, 100 microg of thyroxine or placebo was given daily to 446 thyroid-antibody-positive women (342 of whom were compliant) from 6 weeks to 6 months post-partum, assessing their psychiatric and thyroid status at 4-weekly intervals.


RESULTS
There was no evidence that thyroxine had any effect on the occurrence of depression. The 6-month period prevalence of depression was similar to that reported previously.


CONCLUSIONS
The excess of depression in thyroid-antibody-positive women in the post-partum period is not corrected by daily administration of thyroxine.
Harris
Brian
B
Department of Psychological Medicine, Bronllys Hospital, Brecon, UK. brianharris@totalise.co.uk
Oretti
Rossana
R
Lazarus
John
J
Parkes
Arthur
A
John
Rees
R
Richards
Colin
C
Newcombe
Robert
R
Hall
Reginald
R
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis; D019052:Depression, Postpartum / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D018709:Statistics, Nonparametric; D013959:Thyroid Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D013960:Thyroid Function Tests; D013961:Thyroid Gland / Q000276:immunology; D013974:Thyroxine / Q000627:therapeutic use*
D001323:Autoantibodies; D013974:Thyroxine