Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature
Does thyroid supplementation accelerate tricyclic antidepressant response? A review and meta-analysis of the literature
复制标题
DOI：
10.1176/appi.ajp.158.10.1617
复制
发表时间：
2001-10-01
影响因子：
17.7
通讯作者：
Whybrow, PC
中科院分区：
文献类型：
--
作者：
Altshuler, LL;Bauer, M;Whybrow, PC
目的：抗抑郁药的治疗反应延迟仍然是抑郁症治疗中的一个主要问题。在加速治疗反应的策略中，早期在抗抑郁药中添加甲状腺激素被认为是一种可行的方法。作者对有关使用甲状腺激素补充剂加速抑郁症治疗的文献进行了荟萃分析，以确定是否有足够的证据支持该策略的临床疗效。方法：对美国国家医学图书馆 MEDLINE 进行计算机辅助检索和手动深入检索，以识别所有评估甲状腺激素和抗抑郁药联合给药以加速非难治性抑郁症患者临床反应的双盲、安慰剂对照研究。结果：六项研究确定。所有试验均使用三碘甲状腺原氨酸 (T-3) 和三环类抗抑郁药进行。六项研究中有五项发现 T-3 在加速临床反应方面比安慰剂更有效。汇总加权效应量指数为 0.58，平均效应非常显着。此外，随着参与研究的女性比例增加，T-3 加速的效果也更大。结论：这项荟萃分析支持 T-3 在加速非难治性抑郁症患者对三环类抗抑郁药的临床反应方面的功效。此外，女性可能比男性更有可能从这种干预措施中受益。
objective: The delayed onset of therapeutic response to antidepressants remains a major problem in the treatment of depression. Among the strategies to accelerate response to treatment, the early addition of thyroid hormone to antidepressants has been suggested as a viable method. The authors performed a metaanalysis of the literature on the use of thyroid hormone supplementation to accelerate the treatment of depression to determine whether there is sufficient evidence to support the clinical efficacy of this strategy.Method: Both a computer-aided search of the National Library of Medicine MEDLINE and an intensive search by hand were conducted to identify all double-blind, placebo-controlled studies assessing the concomitant administration of thyroid hormone and antidepressant to accelerate clinical response in patients with nonrefractory depression.Results: Six studies were identified. All were conducted with triiodothyronine (T-3) and a tricyclic antidepressant. Five of the six studies found T-3 to be significantly more effective than placebo in accelerating clinical response. The pooled, weighted effect size index was 0.58, and the average effect was highly significant. Further, the effects of T-3 acceleration were greater as the percentage of women participating in the study increased.Conclusions: This meta-analysis supports the efficacy of T-3 in accelerating clinical response to tricyclic antidepressants in patients with nonrefractory depression. Furthermore, women may be more likely than men to benefit from this intervention.