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Thyroxine Augmentation of Fluoxetine Treatment for Resistant Depression in the Elderly: An Open Trial
Author(s) -
BARAK YORAM,
STEIN DANIEL,
LEVINE JOSEPH,
RING ALIZA,
HADJEZ JACK,
ELIZUR AVNER,
SHOSHANI DAVID
Publication year - 1996
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/(sici)1099-1077(199611)11:6<463::aid-hup816>3.0.co;2-h
Subject(s) - fluoxetine , depression (economics) , medicine , antidepressant , confounding , rating scale , adverse effect , lithium (medication) , psychology , serotonin , hippocampus , macroeconomics , developmental psychology , receptor , economics
Drug resistant depression is a confounding entity. More so in populations of elderly depressives where addition of lithium or antidepressant combinations are possibly hazardous. We present an open‐trial of thyroxine in elderly patients diagnosed as suffering from resistant depression. Methods—Thyroxine 50 mcg/day was added to fluoxetine 20 mg/day in patients who did not respond to previous, non‐SSRI, antidepressant treatment (6 weeks), nor to an additional 6 weeks of fluoxetine. Subjects—Subjects were diagnosed as suffering from major depression, according to DSM‐III‐R criteria. All had normal thyroid function tests (TSH and FT 4 ). There were 15 patients in our series: nine females, six males; mean age 72·1 years (±6·5). Results—Patients depression severity was graded using the Hamilton Depression Rating Scale at baseline (before thyroxine augmentation), and 4 weeks after initiation of treatment. Ten of 15 patients responded to thyroxine augmentation (HDRS<10), 3/15 showed no improvement of HDRS scores and two dropped out due to adverse effects: diarrhoea and tachycardia. Conclusions—Thyroxine augmentation of fluoxetine is effective in elderly subjects resistant to standard treatment, and is relatively safe.