title: Thyroid autoimmunity and treatment response to escitalopram in major depression.
abstract: BACKGROUND
  There is evidence that immune alterations play an important part in the pathogenesis of major depression. Thyroid autoimmunity has been found in association with major depression in several studies.
  
  
  OBJECTIVE
  1) to examine whether the prevalence of anti-thyroid peroxidase autoantibodies (anti-TPO) in depressive patients differs from that in healthy controls; 2) to investigate the possible relationship between thyroid autoimmunity, total T3, free T3, free T4, thyroid-stimulating hormone (TSH), clinical status and treatment outcome in depression.
  
  
  METHODS
  The study group consisted of 129 outpatients (69.8% female; mean age 31.7+/-12.0 years) with major depressive disorder with a Montgomery-Azsberg Depression Rating Scale total score of 22 or higher and 72 healthy controls (62.5% female; mean age 31.7+/-13.1 years). The patients were treated with escitalopram 10-20 mg/day for 12 weeks using open-label placebo non-controlled design. Anti-TPO, total T3, free T3, free T4 and TSH were measured before the treatment.
  
  
  RESULTS
  The anti-TPO was found in eight (8.9%) depressive and two (4.8%) healthy females without statistical difference between these groups. Since anti-TPO was not seen in males, all further statistical analyses were carried out in females. At the end of week 12 of the treatment, 60 female patients (66.7%) were defined as responders and 30 depressive females (33.3%) showed insufficient response to treatment. Although there were no significant differences in the measurements between responders and non-responders, the last group showed a trend for a higher prevalence of anti-TPO compared with responders.
  
  
  CONCLUSIONS
  Thyroid autoimmunity might be a factor predicting treatment response to antidepressants in depressive patients.
authors.affiliation: Department of Psychiatry, University of Tartu, Raja 31, 50417 Tartu, Estonia.
authors.forename: Triin
authors.initials: T
authors.lastname: Eller
authors.forename: Kaja
authors.initials: K
authors.lastname: Metsküla
authors.forename: Ija
authors.initials: I
authors.lastname: Talja
authors.forename: Eduard
authors.initials: E
authors.lastname: Maron
authors.forename: Raivo
authors.initials: R
authors.lastname: Uibo
authors.forename: Veiko
authors.initials: V
authors.lastname: Vasar
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000097:blood / Q000276:immunology / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D015283:Citalopram / Q000097:blood / Q000276:immunology / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D008297:Male; D013967:Thyroiditis, Autoimmune / Q000097:blood / Q000150:complications* / Q000276:immunology; D013972:Thyrotropin / Q000097:blood / Q000276:immunology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018687:Antidepressive Agents, Second-Generation; D001323:Autoantibodies; D015283:Citalopram; D013972:Thyrotropin