Depression & Hypothyroidism: 8 Clinical Facts

References:

  1. Minerva Endocrinol. 2013 Dec;38(4):365-77. (pubmed)
  2. J Affect Disord. 2014 Dec;169:112-7. (pubmed)
  3. Arch Intern Med. 2010 Dec 13;170(22):1996-2003. (pubmed)
  4. Psychoneuroendocrinology. 2015 Aug;58:114-9. (pubmed)

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Read the following chapters discussing the role of hypothyroidism in psychiatry:

(1) Subclinical Hypothyroidism: Will you initiate thyroid replacement therapy? 

  • Risk factors for high and low TSH level.
  • USPSTF Screening Recommendation for thyroid dysfunction.
  • When will you initiate thyroid replacement therapy in subclinical hypothyroidism?
  • How to dose and time of levothyroxine?
  • Does levothyroxine replacement therapy for subclinical hypothyroidism result in improved survival or decreased cardiovascular morbidity?
  • Which medications may result in hypothyroidism?

(2) MDD Augmentation with Thyroid Hormones.

  • Which one is preferred for depression augmentation treatment: T3 or T4?
  • How to initiate and titrate Cytomel (Liothyronine) as augmentation for depression management?
  • Cautions and Contraindications for Cytomel (Liothyronine) treatment.
  • Important Drug Interactions with Cytomel (Liothyronine)
  • What is the duration for augmentation with T3 in resistant depression?
  • What are the recommended safety guidelines for T3 augmentation of antidepressants?

(3) Lithium induced Hypothyroidism.

  • Underlying mechanism of action.
  • Risk factors for lithium induced hypothyroidism.
  • Monitoring recommendations.
  • Management recommendations.

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