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Vagus Nerve Stimulation As an Adjunctive Neurostimulation Tool in Treatment-resistant Depression

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Long term augmentation with T3 in refractory major depression.

Tammas F Kelly¹, Daniel Z Lieberman

¹The Depression and Bipolar Clinic of Colorado, 315 West Oak Street, Fort Collins, Colorado 80521, United States. TamKellyNews@gmail.com

Journal of Affective Disorders

|December 26, 2008

Summary

Long-term, high-dose triiodothyronine (T3) augmentation effectively treated refractory unipolar major depression in 14 of 17 patients. This study suggests increasing T3 doses beyond 50 mcg for sustained symptom improvement.

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Area of Science:

Neuroscience
Psychiatry
Pharmacology

Background:

Triiodothyronine (T3) is a well-researched augmentation strategy for treatment-resistant depression.
Existing research lacks long-term studies and investigations into T3 doses exceeding 100 mcg.

Purpose of the Study:

To evaluate the efficacy and safety of long-term, high-dose T3 augmentation in patients with refractory unipolar major depression.
To determine if increasing T3 dosage beyond traditional levels improves treatment outcomes.

Main Methods:

A case series involving 17 patients with refractory unipolar major depression.
Patients received long-term T3 augmentation, with doses adjusted over time.
Symptom improvement was assessed using the Clinical Global Impression of Improvement (CGI-I) Scale.

Main Results:

14 out of 17 patients (82%) demonstrated significant symptom improvement.
The average CGI-I score for improved patients was 2.5.
Average T3 dose was 80 mcg (range: 25-150 mcg), and average treatment duration was 24.2 months.

Conclusions:

Long-term T3 augmentation, with gradually increased doses, can be a successful strategy for managing refractory major depression.
Higher T3 doses may be necessary for sustained efficacy in this patient population.
Further research is warranted to confirm these findings and optimize T3 dosing protocols.