Triiodothyronine Augmentation of Selective Serotonin Reuptake Inhibitors in Posttraumatic Stress Disorder
J Clin Psychiatry 2001;62;169-173
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: There is considerable comorbidity of
major depression and posttraumatic stress disorder (PTSD), and
antidepressants have been reported to be effective in treating
PTSD. Addition of triiodothyronine (T3) to ongoing
antidepressant treatment is considered an effective augmentation
strategy in refractory depression. We report the effect of T3
augmentation of antidepressants in patients with PTSD.
Method: T3 (25 microg/day) was added
to treatment with a selective serotonin reuptake inhibitor (SSRI)
(paroxetine or fluoxetine, 20 mg/day for at least 4 weeks and 40
mg/day for a further 4 weeks) of 5 patients who fulfilled DSM-IV
criteria for PTSD but not for major depressive disorder (although
all patients had significant depressive symptoms). The
Clinician-Administered PTSD Scale, the 21-item Hamilton Rating
Scale for Depression, and the Clinical Global
Impressions-Severity of Illness scale were administered every 2
weeks, and self-assessments were performed with a 100 mm visual
analog mood scale.
Results: In 4 of the 5 patients, partial
clinical improvement was observed with SSRI treatment at a daily
dose of 20 mg with little further improvement when the dose was
raised to 40 mg/day. This improvement was substantially enhanced
by the addition of T3. Improvement was most striking
on the Hamilton Rating Scale for Depression.
Conclusion: T3 augmentation of SSRI
treatment may be of therapeutic benefit in patients with PTSD,
particularly those with depressive symptoms. Larger samples and
controlled studies are needed in order to confirm this