Does a Combination Regimen of Thyroxine (T4) and 3,5,3′-Triiodothyronine Improve Depressive Symptoms Better Than T4 Alone in Patients with Hypothyroidism? Results of a Double-Blind, Randomized, Controlled Trial
Some hypothyroid patients receiving levothyroxine replacement therapy complain of depressive symptoms despite normal TSH measurements. It is not known whether adding T3 can reverse such symptoms. We randomized 40 individuals with depressive symptoms who were taking a stable dose of levothyroxine for...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2003-10, Vol.88 (10), p.4551-4555 |
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| container_title | The journal of clinical endocrinology and metabolism |
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| creator | Sawka, A. M. Gerstein, H. C. Marriott, M. J. MacQueen, G. M. Joffe, R. T. |
| description | Some hypothyroid patients receiving levothyroxine replacement therapy complain of depressive symptoms despite normal TSH measurements. It is not known whether adding T3 can reverse such symptoms. We randomized 40 individuals with depressive symptoms who were taking a stable dose of levothyroxine for treatment of hypothyroidism (excluding those who underwent thyroidectomy or radioactive iodine ablation of the thyroid) to receive T4 plus placebo or the combination of T4 plus T3 in a double-blind manner for 15 wk. Participants receiving combination therapy had their prestudy dose of T4 dropped by 50%, and T3 was started at a dose of 12.5 μg, twice daily. T4 and T3 doses were adjusted to keep goal TSH concentrations within the normal range. Compared with the group taking T4 alone, the group taking both T4 plus T3 did not report any improvement in self-rated mood and well-being scores that included all subscales of the Symptom Check-List-90, the Comprehensive Epidemiological Screen for Depression, and the Multiple Outcome Study (P > 0.05 for all indexes). In conclusion, the current data do not support the routine use of combined T3 and T4 therapy in hypothyroid patients with depressive symptoms. |
| doi_str_mv | 10.1210/jc.2003-030139 |
| format | Article |
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Results of a Double-Blind, Randomized, Controlled Trial</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Sawka, A. M. ; Gerstein, H. C. ; Marriott, M. J. ; MacQueen, G. M. ; Joffe, R. T.</creator><creatorcontrib>Sawka, A. M. ; Gerstein, H. C. ; Marriott, M. J. ; MacQueen, G. M. ; Joffe, R. T.</creatorcontrib><description>Some hypothyroid patients receiving levothyroxine replacement therapy complain of depressive symptoms despite normal TSH measurements. It is not known whether adding T3 can reverse such symptoms. We randomized 40 individuals with depressive symptoms who were taking a stable dose of levothyroxine for treatment of hypothyroidism (excluding those who underwent thyroidectomy or radioactive iodine ablation of the thyroid) to receive T4 plus placebo or the combination of T4 plus T3 in a double-blind manner for 15 wk. Participants receiving combination therapy had their prestudy dose of T4 dropped by 50%, and T3 was started at a dose of 12.5 μg, twice daily. T4 and T3 doses were adjusted to keep goal TSH concentrations within the normal range. Compared with the group taking T4 alone, the group taking both T4 plus T3 did not report any improvement in self-rated mood and well-being scores that included all subscales of the Symptom Check-List-90, the Comprehensive Epidemiological Screen for Depression, and the Multiple Outcome Study (P > 0.05 for all indexes). In conclusion, the current data do not support the routine use of combined T3 and T4 therapy in hypothyroid patients with depressive symptoms.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2003-030139</identifier><identifier>PMID: 14557420</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Adult ; Adult and adolescent clinical studies ; Affect - drug effects ; Biological and medical sciences ; Depression - drug therapy ; Depression - etiology ; Double-Blind Method ; Drug Therapy, Combination ; Endocrinopathies ; Epidemiology ; Female ; Hormones. Endocrine system ; Humans ; Hypothyroidism ; Hypothyroidism - complications ; Hypothyroidism - drug therapy ; Hypothyroidism - psychology ; Iodine ; Male ; Medical sciences ; Mental depression ; Middle Aged ; Miscellaneous ; Mood disorders ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Pharmacology. Drug treatments ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Thyroid Gland - drug effects ; Thyroid Gland - physiology ; Thyroid hormones ; Thyroid-stimulating hormone ; Thyroid. Thyroid axis (diseases) ; Thyroidectomy ; Thyroxine ; Thyroxine - administration & dosage ; Thyroxine - blood ; Treatment Outcome ; Triiodothyronine ; Triiodothyronine - administration & dosage ; Triiodothyronine - blood</subject><ispartof>The journal of clinical endocrinology and metabolism, 2003-10, Vol.88 (10), p.4551-4555</ispartof><rights>Copyright © 2003 by The Endocrine Society 2003</rights><rights>Copyright © 2003 by The Endocrine Society</rights><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15207752$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14557420$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sawka, A. M.</creatorcontrib><creatorcontrib>Gerstein, H. C.</creatorcontrib><creatorcontrib>Marriott, M. J.</creatorcontrib><creatorcontrib>MacQueen, G. M.</creatorcontrib><creatorcontrib>Joffe, R. T.</creatorcontrib><title>Does a Combination Regimen of Thyroxine (T4) and 3,5,3′-Triiodothyronine Improve Depressive Symptoms Better Than T4 Alone in Patients with Hypothyroidism? Results of a Double-Blind, Randomized, Controlled Trial</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Some hypothyroid patients receiving levothyroxine replacement therapy complain of depressive symptoms despite normal TSH measurements. It is not known whether adding T3 can reverse such symptoms. We randomized 40 individuals with depressive symptoms who were taking a stable dose of levothyroxine for treatment of hypothyroidism (excluding those who underwent thyroidectomy or radioactive iodine ablation of the thyroid) to receive T4 plus placebo or the combination of T4 plus T3 in a double-blind manner for 15 wk. Participants receiving combination therapy had their prestudy dose of T4 dropped by 50%, and T3 was started at a dose of 12.5 μg, twice daily. T4 and T3 doses were adjusted to keep goal TSH concentrations within the normal range. Compared with the group taking T4 alone, the group taking both T4 plus T3 did not report any improvement in self-rated mood and well-being scores that included all subscales of the Symptom Check-List-90, the Comprehensive Epidemiological Screen for Depression, and the Multiple Outcome Study (P > 0.05 for all indexes). In conclusion, the current data do not support the routine use of combined T3 and T4 therapy in hypothyroid patients with depressive symptoms.</description><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Affect - drug effects</subject><subject>Biological and medical sciences</subject><subject>Depression - drug therapy</subject><subject>Depression - etiology</subject><subject>Double-Blind Method</subject><subject>Drug Therapy, Combination</subject><subject>Endocrinopathies</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Hormones. Endocrine system</subject><subject>Humans</subject><subject>Hypothyroidism</subject><subject>Hypothyroidism - complications</subject><subject>Hypothyroidism - drug therapy</subject><subject>Hypothyroidism - psychology</subject><subject>Iodine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Mood disorders</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Thyroid Gland - drug effects</subject><subject>Thyroid Gland - physiology</subject><subject>Thyroid hormones</subject><subject>Thyroid-stimulating hormone</subject><subject>Thyroid. Thyroid axis (diseases)</subject><subject>Thyroidectomy</subject><subject>Thyroxine</subject><subject>Thyroxine - administration & dosage</subject><subject>Thyroxine - blood</subject><subject>Treatment Outcome</subject><subject>Triiodothyronine</subject><subject>Triiodothyronine - administration & dosage</subject><subject>Triiodothyronine - blood</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkt9u0zAUxiMEYmVwyyWyhIaY1Az_jZsrtLXAJk0CjSJxFznJCXVx7GAnlHLFM_EsPAFPgkOLiuYL-1j-nc-ffU6SPCb4jFCCX6yrM4oxSzHDhOV3kgnJuUglyeXdZIIxJWku6cej5EEIa4wJ54LdT44IF0JyiifJr4WDgBSau7bUVvXaWXQDn3QLFrkGLVdb775pC-j5kp8iZWvEpmLKfv_4mS691q52_YjYEblqO---AlpA5yEEHcP327brXRvQBfQ9-KinLFpydG5cTNAWvYtXgu0D2uh-hS633U5P1zq0L6OTMJh4GJ0otHBDaSC9MNrWU3QTvbhWf4cYz53tvTMGahRNKfMwudcoE-DRfj1OPrx-tZxfptdv31zNz69ToExmKRWqwhkmVJRVwzPBZnWtuMQNrUWZY17nipY0q8SMQsOIooQwXmOhSprjmVLsOHm2043v_jJA6ItWhwqMURbcEApJqKSUZBF8egtcu8Hb6K1g8VjiLHKRerKnhrKFuui8bpXfFv-qFYGTPaBCpUzjla10OHCCYinFKMR33MaZ-Ovhsxk24IsVKNOvChwHz-QsHRuHjLt0nEaXp7s0N3QHUVyMjVasq-K_Rous2LEQy1D5WP6_NT-861Zesc_7A8-F0po</recordid><startdate>200310</startdate><enddate>200310</enddate><creator>Sawka, A. M.</creator><creator>Gerstein, H. C.</creator><creator>Marriott, M. J.</creator><creator>MacQueen, G. M.</creator><creator>Joffe, R. T.</creator><general>Endocrine Society</general><general>Oxford University Press</general><general>Copyright by The Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>200310</creationdate><title>Does a Combination Regimen of Thyroxine (T4) and 3,5,3′-Triiodothyronine Improve Depressive Symptoms Better Than T4 Alone in Patients with Hypothyroidism? Results of a Double-Blind, Randomized, Controlled Trial</title><author>Sawka, A. M. ; Gerstein, H. C. ; Marriott, M. J. ; MacQueen, G. M. ; Joffe, R. T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e2376-25ac060125bcf46538dda470f2d5b904d9a2b26c582ef31a21134d05ab2908aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Affect - drug effects</topic><topic>Biological and medical sciences</topic><topic>Depression - drug therapy</topic><topic>Depression - etiology</topic><topic>Double-Blind Method</topic><topic>Drug Therapy, Combination</topic><topic>Endocrinopathies</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Hormones. Endocrine system</topic><topic>Humans</topic><topic>Hypothyroidism</topic><topic>Hypothyroidism - complications</topic><topic>Hypothyroidism - drug therapy</topic><topic>Hypothyroidism - psychology</topic><topic>Iodine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Mood disorders</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Thyroid Gland - drug effects</topic><topic>Thyroid Gland - physiology</topic><topic>Thyroid hormones</topic><topic>Thyroid-stimulating hormone</topic><topic>Thyroid. Thyroid axis (diseases)</topic><topic>Thyroidectomy</topic><topic>Thyroxine</topic><topic>Thyroxine - administration & dosage</topic><topic>Thyroxine - blood</topic><topic>Treatment Outcome</topic><topic>Triiodothyronine</topic><topic>Triiodothyronine - administration & dosage</topic><topic>Triiodothyronine - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sawka, A. M.</creatorcontrib><creatorcontrib>Gerstein, H. C.</creatorcontrib><creatorcontrib>Marriott, M. J.</creatorcontrib><creatorcontrib>MacQueen, G. M.</creatorcontrib><creatorcontrib>Joffe, R. 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T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does a Combination Regimen of Thyroxine (T4) and 3,5,3′-Triiodothyronine Improve Depressive Symptoms Better Than T4 Alone in Patients with Hypothyroidism? Results of a Double-Blind, Randomized, Controlled Trial</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2003-10</date><risdate>2003</risdate><volume>88</volume><issue>10</issue><spage>4551</spage><epage>4555</epage><pages>4551-4555</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Some hypothyroid patients receiving levothyroxine replacement therapy complain of depressive symptoms despite normal TSH measurements. It is not known whether adding T3 can reverse such symptoms. We randomized 40 individuals with depressive symptoms who were taking a stable dose of levothyroxine for treatment of hypothyroidism (excluding those who underwent thyroidectomy or radioactive iodine ablation of the thyroid) to receive T4 plus placebo or the combination of T4 plus T3 in a double-blind manner for 15 wk. Participants receiving combination therapy had their prestudy dose of T4 dropped by 50%, and T3 was started at a dose of 12.5 μg, twice daily. T4 and T3 doses were adjusted to keep goal TSH concentrations within the normal range. Compared with the group taking T4 alone, the group taking both T4 plus T3 did not report any improvement in self-rated mood and well-being scores that included all subscales of the Symptom Check-List-90, the Comprehensive Epidemiological Screen for Depression, and the Multiple Outcome Study (P > 0.05 for all indexes). In conclusion, the current data do not support the routine use of combined T3 and T4 therapy in hypothyroid patients with depressive symptoms.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>14557420</pmid><doi>10.1210/jc.2003-030139</doi><tpages>5</tpages></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Adult and adolescent clinical studies Affect - drug effects Biological and medical sciences Depression - drug therapy Depression - etiology Double-Blind Method Drug Therapy, Combination Endocrinopathies Epidemiology Female Hormones. Endocrine system Humans Hypothyroidism Hypothyroidism - complications Hypothyroidism - drug therapy Hypothyroidism - psychology Iodine Male Medical sciences Mental depression Middle Aged Miscellaneous Mood disorders Non tumoral diseases. Target tissue resistance. Benign neoplasms Pharmacology. Drug treatments Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Thyroid Gland - drug effects Thyroid Gland - physiology Thyroid hormones Thyroid-stimulating hormone Thyroid. Thyroid axis (diseases) Thyroidectomy Thyroxine Thyroxine - administration & dosage Thyroxine - blood Treatment Outcome Triiodothyronine Triiodothyronine - administration & dosage Triiodothyronine - blood |
| title | Does a Combination Regimen of Thyroxine (T4) and 3,5,3′-Triiodothyronine Improve Depressive Symptoms Better Than T4 Alone in Patients with Hypothyroidism? Results of a Double-Blind, Randomized, Controlled Trial |
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