Peripheral thyroid hormones and response to selective serotonin reuptake inhibitors.
OBJECTIVE
To examine the relation between baseline measurements of thyroid function and response to selective serotonin reuptake inhibitors (SSRIs) and to consider the effect of these antidepressants on thyroid hormone levels.


METHODS
Nineteen subjects with major depression, but without a history of thyroid treatment or lithium treatment, were treated openly with either sertraline or fluoxetine in a university- affiliated tertiary care hospital. Hamilton Depression Rating Scale (Ham-D) scores were measured before and after treatment. Clinical Global Impressions (CGI) scores were measured at study end. Thyroid data, consisting of values for thyroid-stimulating hormone (TSH), triiodothyronine (T(3), measured by radioimmunoassay [RIA]), thyroxine (T(4), measured by RIA) and free T(4), were collected before and after treatment. Complete thyroid data were available for 17 subjects. Data were collected during 1997-1999.


RESULTS
Baseline TSH correlated strongly with response to treatment as measured by change in Ham-D scores (r = 0.64, p = 0.003). Low TSH values correlated with greater improvement in depressive symptoms. Thyroid hormone levels decreased with treatment, but these decreases did not correlate with clinical improvement.


CONCLUSIONS
Baseline thyroid function, as measured by serum TSH, may predict a patient's response to antidepressant treatment with SSRIs. Optimal thyroid function, beyond simply being within the normal laboratory values, may be necessary for an optimal response to antidepressants.
Department of Psychiatry, UCLA School of Medicine, Los Angeles, CA 90095, USA. mgitlin@mednet.ucla.edu
Michael
M
Gitlin
Lori L
LL
Altshuler
Mark A
MA
Frye
Rita
R
Suri
Emily L
EL
Huynh
Lynn
L
Fairbanks
Michael
M
Bauer
Stanley
S
Korenman
D000293:Adolescent; D000328:Adult; D003865:Major Depressive Disorder / Q000097:blood / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D013963:Thyroid Hormones / Q000097:blood*
D017367:Selective Serotonin Reuptake Inhibitors; D013963:Thyroid Hormones