Thyroxine Augmentation of Fluoxetine Treatment for Resistant Depression in the Elderly: An Open Trial
✍ Scribed by YORAM BARAK; DANIEL STEIN; JOSEPH LEVINE; ALIZA RING; JACK HADJEZ; AVNER ELIZUR; DAVID SHOSHANI
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 415 KB
- Volume
- 11
- Category
- Article
- ISSN
- 0885-6222
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✦ Synopsis
Drug resistant depression is a confounding entity. More so in populations of elderly depressives where addition of lithium or antidepressant combinations are possibly hazardous. We present an open-trial of thyroxine in elderly patients diagnosed as suffering from resistant depression. Methods -Thyroxine 50 mcg/day was added to fluoxetine 20 mg/day in patients who did not respond to previous, non-SSRI, antidepressant treatment (6 weeks), nor to an additional 6 weeks of fluoxetine. Subjects -Subjects were diagnosed as suffering from major depression, according to DSM-III-R criteria. All had normal thyroid function tests (TSH and FT4). There were 15 patients in our series: nine females, six males; mean age 72.1 years ( f 6.5). Results -Patients depression severity was graded using the Hamilton Depression Rating Scale at baseline (before thyroxine augmentation), and 4 weeks after initiation of treatment. Ten of 15 patients responded to thyroxine augmentation (HDRS < lo), 3/15 showed no improvement of HDRS scores and two dropped out due to adverse effects: diarrhoea and tachycardia.
Conclusions -Thyroxine augmentation of fluoxetine is effective in elderly subjects resistant to standard treatment, and is relatively safe.