April, 2003 -- Israeli experts have found that as many as half of all patients experiencing unipolar and non-psychotic major depression do not respond to initial selective serotonin reuptake inhibitor (SSRI) antidepressant treatment. As a result, the researchers have developed a formula of progressively increased doses of prescribed antidepressant drug, usually Prozac (fluoxetine). And those who are unresponsive also receive triiodothyronine (T3), from 25 to 50 micrograms per day.

In research reported on in the International Journal of Neuropsychopharmacology, 81 patients were started on fluoxetine 20 mg; and 9 patients received paroxetine, and at four weeks, 74 completed treatment, and at that time, 44 0-- or 48.9% -- responded to the regimen. An additional 5 patients (16.6%) responded when the SSRI dose was raised to 40 mg two weeks. Patients who did not respond to SSRI treatment were evaluated at the onset to be far more depressed.

T3 was added, and found to be effectiver among 10 out of 16 women patients (62.5%), but was not effective in any of the 9 male patients who received it. Although values were within the normal range, patients who responded to T3 had higher serum thyroid-stimulating hormone (TSH) levels than those who did not.

The researchers speculate that the effect of T3 may be related to thyroid function even within the normal range.


Source: "Algorithm-based treatment of major depression in an outpatient clinic: clinical correlates of response to a specific serotonin reuptake inhibitor and to triiodothyronine augmentation" Int J Neuropsychopharmacology 2003;6:41-49.

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