Thyroid hormones affect recovery from depression during antidepressant treatment.
OBJECTIVE
The aim of the present study was to evaluate whether thyroid hormonal changes during menopause may affect the development and the course of major depressive disorder.


METHODS
Thirty-nine female patients (n = 17 in pre-menopause; n = 22 in post-menopause) with major depressive disorder based on Diagnostic Statistical Manual of Mental Disorders (4th edition) criteria and who were euthyroid and not on hormonal replacement therapy, participated in a prospective, 6-week, open-label naturalistic study. The Hamilton Depression Rating Scale-17 item, the Montgomery-Asberg Depression Rating Scale, the Clinical Global Impression scale and the Cognitive Failure Questionnaire were administered at baseline, week 1, week 3, and week 6. Levels of thyroid stimulating hormone, total thyroxine and total triiodothyronine were collected at baseline visit.


RESULTS
In the whole sample, particularly in pre-menopausal women, levels of thyroid stimulating hormone-potential markers of subclinical hypothyroidism were correlated with those of less severe but more resistant depressive form. Conversely, total thyroxine levels were correlated with a more severe depression, but high levels of this hormone favored the response to antidepressants. Overall, a diagnosis of subclinical hypothyroidism was associated with a poor response to antidepressant treatment. Finally, total triiodothyronine levels were associated with better cognitive functioning, though they did not influence improvement occurring with recovery.


CONCLUSIONS
Our study suggests that thyroid hormones may have an impact on severity and efficacy of antidepressant treatment. However, our result should be considered with caution and merely as a suggestion due to some methodological limitations. Hence further studies are required to better ascertain the role of thyroid hormones in depression after menopause.
Pae
Chi-Un
CU
Department of Psychiatry, Holy Family Hospital, The Catholic University of Korea College of Medicine, Bucheon, Kyoung-gi Province, Republic of Korea. alessandro.serretti@unibo.it
Mandelli
Laura
L
Han
Changsu
C
Ham
Byung-Joo
BJ
Masand
Prakash S
PS
Patkar
Ashwin A
AA
Steffens
David C
DC
De Ronchi
Diana
D
Serretti
Alessandro
A
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D003865:Major Depressive Disorder / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood; D017697:Premenopause / Q000097:blood; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood*
D000928:Antidepressive Agents; D013963:Thyroid Hormones; D013972:Thyrotropin