Effects of supraphysiological thyroxine administration in healthy controls and patients with depressive disorders.
BACKGROUND
Thyroxine (T(4)) in supraphysiological doses has been found to be an effective supplemental treatment in open studies for refractory mood disorders. Unexpectedly, only minimal side effects have been reported. The goal of the present study was to investigate whether healthy controls and depressed patients differ in their ability to tolerate supraphysiological doses of T(4).


METHODS
This was an 8-week open study to investigate side effects and levels of thyroid hormones in 13 healthy controls and to compare results with those of 13 patients with refractory depression (unipolar and bipolar) undergoing the similar procedures and T(4) dosing regimen in a previous augmentation study.


RESULTS
The rate of discontinuation due to side effects was significantly higher in the control group than for the patients (38% versus 0%). The severity of the side effects in the controls increased significantly during treatment with T(4). The side effect scores of the patients were higher than those of the controls prior to T(4) treatment, but did not change significantly during the treatment period. Although the serum concentrations of thyroid hormones rose significantly in both groups, concentrations of fT(3) and fT(4) were significantly higher in the controls.


CONCLUSIONS
Healthy controls and depressed patients respond significantly differently to supraphysiological T(4). Healthy controls experience higher elevations of thyroid hormones in response to supraphysiological T(4), thus inducing significantly more side effects and discontinuation.


CONCLUSIONS
Open-label study; groups were studied at different times; in contrast to healthy controls, depressed patients were also taking antidepressants.


CONCLUSIONS
Studies provide safety and tolerability data on treatment with supraphysiological doses of T(4).
Bauer
Michael
M
Department of Psychiatry, Klinikum Benjamin Franklin, Freie Universität Berlin, Berlin, Germany. mjbauer@mednet.ucla.edu
Baur
Hiltrud
H
Berghöfer
Anne
A
Ströhle
Andreas
A
Hellweg
Rainer
R
Müller-Oerlinghausen
Bruno
B
Baumgartner
Andreas
A
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000928:Antidepressive Agents / Q000008:administration & dosage; D001714:Bipolar Disorder / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D013960:Thyroid Function Tests; D013974:Thyroxine / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D016896:Treatment Outcome
D000928:Antidepressive Agents; D013974:Thyroxine