Combined Use of Thyroid Hormone and ECT

Neurocognitive deficits, including acute confusion and memory impairment, remain important effects of electroconvulsive therapy (ECT). Laboratory and clinical research demonstrates interactions among neurocognitive functioning, the hypothalmic-pituitary-thyroid axis, depressive mood, and ECT. Preclinical studies have demonstrated that exogenous triiodothyronine (T(3)) administered to animals receiving electroconvulsive shock (ECS) protects against ECS-related amnesia and accelerates the "antidepressant effects" of ECS, possibly due to alterations in catecholamine and/or indoleamine neurotransmission. Clinical data suggest that combined treatment with T(3) and ECT results in increased clinical efficacy of ECT and diminished neurocognitive side effects.