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Slower treatment response in bipolar depression predicted by lower pretreatment thyroid function.
Daniel P Cole1, Michael E Thase, Alan G Mallinger
1Department of Psychiatry, University of Pittsburgh School of Medicine, USA.
The American Journal of Psychiatry
|January 5, 2002
Summary
Thyroid function within the normal range impacts bipolar depression treatment. Lower free thyroxine index (FTI) and higher thyroid-stimulating hormone (TSH) levels were linked to slower antidepressant response in bipolar I disorder patients.
Area of Science:
- Neuroscience
- Endocrinology
- Psychiatry
Background:
- Treatment of bipolar depression is challenging.
- Hypothyroidism is linked to depression.
- Thyroid function may influence antidepressant response.
Purpose of the Study:
- Examine the relationship between pretreatment thyroid values and antidepressant treatment response in bipolar I disorder.
- Hypothesize that lower thyroid function, even within the normal range, leads to poorer treatment response.
Main Methods:
- 65 patients with bipolar I depression were studied.
- Pretreatment thyroid measures (TSH, thyroxine, triiodothyronine resin uptake, FTI) were assessed.
- Cox proportional hazards model estimated the effect of thyroid measures on time to remission.
Main Results:
- Lower free thyroxine index (FTI) and higher thyroid-stimulating hormone (TSH) were associated with longer remission times.
- Optimal response occurred when FTI was above median and TSH was below median.
- Patients with optimal thyroid profiles achieved remission 4 months faster.
Conclusions:
- Bipolar disorder patients are sensitive to normal-range thyroid function variations.
- Nearly 75% of patients may have suboptimal thyroid profiles for antidepressant response.
- Further research is needed on pharmacological thyroid function enhancement for bipolar depression recovery.