Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-25T11:01:31.418Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors of Response to Lithium and Triiodothyronine Augmentation of Antidepressants in Tricyclic Non-responders

Published online by Cambridge University Press:  02 January 2018

Russell T. Joffe ,
Anthony J. Levitt ,
R. Michael Bagby ,
Cathy MacDonald  and
William Singer
Russell T. Joffe*
Affiliation:
Mood Disorders Program, Clarke Institute of Psychiatry and the University of Toronto
Anthony J. Levitt
Affiliation:
Mood Disorders Program, Clarke Institute of Psychiatry and the University of Toronto
R. Michael Bagby
Affiliation:
Mood Disorders Program, Clarke Institute of Psychiatry and the University of Toronto
Cathy MacDonald
Affiliation:
Mood Disorders Program, Clarke Institute of Psychiatry and the University of Toronto
William Singer
Affiliation:
Hormone Assay Laboratory, St Michael's Hospital and the University of Toronto
*
∗Clarke Institute of Psychiatry, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

Although both lithium and triiodothyronine (T3) augmentation strategies may be rapid, safe, and effective ways of treating patients who fail to respond to tricyclics, little is known about the clinical or biochemical correlates of response. We examined clinical and endocrine variables which distinguished T3 and lithium responders from each other and from non-responders in a post-hoc analysis of two studies involving 51 subjects who had received these augmentation strategies under double-blind conditions. Lithium non-responders were more severely depressed and had more insomnia and weight loss than responders. T3 responders could be distinguished from lithium responders by greater weight loss. There were no reliable clinical differences between T3 responders and non-responders. Thyroid function tests did not differ between any of the treatment or response groups. Our findings suggest that clinical but not endocrine variables may distinguish responders to these two augmentation strategies.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 163 , Issue 5 , November 1993 , pp. 574 - 578
Copyright
Copyright © Royal College of Psychiatrists, 1993 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Austin, M. P. V., Souza, F. G. N. & Goodwin, G. M. (1991) Lithium augmentation in antidepressant-resistant patients. A quantitative analysis. British Journal of Psychiatry, 159, 510–514.CrossRefGoogle ScholarPubMed
Banki, C. M. (1975) Triiodothyronine in the treatment of depression. Orvieti Hetilia, 116, 2543–2547.Google ScholarPubMed
Banki, C. M. (1977) Cerebrospinal fluid amine metabolites after combined amitriptyline-triiodothyronine treatment of depressed women. European Journal of Clinical Pharmacology, 11, 311–315.CrossRefGoogle ScholarPubMed
DeMontigny, C., Grunberg, F., Mayer, A., et al (1981) Lithium induces rapid relief of depression in tricyclic antidepressant drug nonresponders. British Journal of Psychiatry, 138, 252–256.CrossRefGoogle Scholar
DeMontigny, C., Cournoyer, G., Morisette, R., et al (1983) Lithium carbonate addition in tricyclic antidepressant-resistant unipolar depression: correlations with the neurobiologie actions of tricyclic antidepressant drugs and lithium iron on the serotonin system. Archives of General Psychiatry, 40, 1327–1334.CrossRefGoogle Scholar
Earle, B. V. (1970) Thyroid hormone and tricyclic antidepressants in resistant depression. American Journal of Psychiatry, 126, 1667–1669.CrossRefGoogle Scholar
Garbutt, J. C., Mayo, J. P. Jr, Gillette, G. M., et al (1986) Lithium potentiation of tricyclic antidepressants following lack of T3 potentiation. American Journal of Psychiatry, 143, 1038–1039.Google ScholarPubMed
Gitlin, M. J., Winer, H., Fairbanks, L., et al (1987) Failure of T3 to potentiate tricyclic antidepressant response. Journal of Affective Disorders, 13, 267–272.CrossRefGoogle ScholarPubMed
Goodwin, F. K., Prange, A. J. Jr, Post, R. M., et al (1982) Potentiation of antidepressant effects by L-triiodothyronine in tricyclic nonresponders. American Journal of Psychiatry, 139, 34–38.Google ScholarPubMed
Hamilton, M. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.CrossRefGoogle ScholarPubMed
Heninger, G. R., Charney, D. S. & Sternberg, D. E. (1983) Lithium carbonate augmentation of antidepressant treatment: an effective prescription for treatment-refractory depression. Archives of General Psychiatry, 40, 1335–1342.CrossRefGoogle ScholarPubMed
Joffe, R. T. (1988) T3 and lithium potentiation of tricyclic antidepressants. American Journal of Psychiatry, 145, 1317–1318.Google ScholarPubMed
Joffe, R. T. & Singer, W. (1990) A comparison of triiodothyronine and thyroxine in the potentiation of tricyclic antidepressants. Psychiatry Research, 32, 241–252.CrossRefGoogle ScholarPubMed
Joffe, R. T., Singer, W., Levitt, A. L., et al (1993) A placebo-controlled comparison of lithium and triiodothyronine augmentation of tricyclic antidepressants in unipolar refractory depression. Archives of General Psychiatry, 50, 387–394.CrossRefGoogle ScholarPubMed
Kantor, D., McNeivin, S., Leichner, P., et al (1986) The benefit of lithium carbonate adjunct in refractory depression: fact or fiction? Canadian Journal of Psychiatry, 31, 416–418.CrossRefGoogle ScholarPubMed
Louie, A. K. & Meltzer, H. Y. (1984) Lithium potentiation of antidepressant treatment. Journal of Clinical Psychopharmacology, 4, 316–321.CrossRefGoogle ScholarPubMed
Nelson, J. C. & Mazure, C. M. (1986) Lithium augmentation in psychotic depression refractory to combine drug treatment. American Journal of Psychiatry, 143, 363–366.Google ScholarPubMed
Ogura, C., Okuma, T., Uchida, Y., et al (1974) Combined thyroid (triiodothyronine)-tricyclic antidepressant treatment in depressed states. Folia Psychiatrica Neurologica Japonica, 28, 179–186.Google Scholar
Price, L. H. (1988) Lithium augmentation and tricyclic-resistant depression. In Treatment of Tricyclic-Resistant Depression (ed. Extein, I.). Washington, DC: American Psychiatric Press.Google Scholar
Price, L. H., Charney, D. S. & Heninger, G. R. (1986) Variability of response to lithium augmentation and refractory depression. American Journal of Psychiatry, 143, 1387–1392.Google ScholarPubMed
Rhoades, H. M. & Overall, J. E. (1983) The Hamilton Depression Scale: factor scoring and profile classification. Psychopharmacology Bulletin, 19, 91–96.Google Scholar
Schopf, J., Baumann, P., Lemarchand, T., et al (1989) Treatment of endogenous depressions resistant to tricyclic antidepressants or related drugs by lithium addition. Results of a placebo-controlled double-blind study. Pharmacopsychiatry, 22, 183–187.CrossRefGoogle ScholarPubMed
Schou, M. (1990) Lithium and treatment-resistant depressions: a review. Lithium, 1, 3–8.Google Scholar
Schwarcz, G., Halaris, A., Baxter, L., et al (1984) Normal thyroid function in desipramine nonresponders compared to responders by the addition of L-triiodothyronine. American Journal of Psychiatry, 141, 1614–1616.Google Scholar
Spitzer, R. L. & Endicott, J. (1978) Schedule of Affective Disorders and Schizophrenia - Lifetime version (SADS-L). New York: State Psychiatric Institute, Biometrics Research.Google Scholar
Spitzer, R. L., & Robins, E. (1978) Research Diagnostic Criteria: rationale and reliability. Archives of General Psychiatry, 35, 773–782.CrossRefGoogle ScholarPubMed
Stein, G. & Bernaot, M. (1988) Double-blind trial of lithium carbonate in tricyclic resistant depression. In Lithium: Inorganic Pharmacology and Psychiatric Use (ed. Birch, N. J.). Oxford: IRL Press.Google Scholar
Tsutsui, S., Yamazaki, Y., Nanba, T., et al (1979) Combined therapy of T3 and antidepressants in depression. Journal of Internal Medicine Research, 7, 138–146.Google ScholarPubMed
Thase, M. E., Kupfer, D. J. & Jarrett, D. B. (1989) Treatment of imipramine-resistant recurrent depression: I. An open clinical trial of adjunctive L-triiodothyronine. Journal of Clinical Psychiatry, 50, 385–388.Google ScholarPubMed
Zusky, P. M., Biederman, J., Rosenbaum, J. F., et al (1988) Adjunct low dose lithium carbonate in treatment-resistant depression: a placebo-controlled study. Journal of Clinical Psychopharmacology, 8, 120–124.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.