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Should thyroid augmentation precede lithium augmentation--a pilot study
1University of Helsinki, Department of Psychiatry, Aleksi Medical Center, Finland.
Background:
It has not been investigated whether thyroid augmentation should precede lithium augmentation or vice versa.
Methods:
In 22 outpatients with major depression not responsive to 4 weeks of antidepressant treatment, the effect of subsequent 4 weeks of thyroxine administration followed by 4 weeks of lithium augmentation was compared with the effect of the same treatments in reverse order.
Results:
The percentage reduction in MADRS score was significantly greater in patients who started on thyroxine.
Conclusions:
Thyroxine augmentation should precede lithium augmentation.
Limitations:
We used relatively small doses of lithium.
Clinical Relevance:
Thyroxine is effective in augmenting antidepressant responses.