Supraphysiological Doses of Levothyroxine as Adjunctive Therapy in Bipolar Depression
| Status: | Completed |
|---|---|
| Conditions: | Depression, Psychiatric, Bipolar Disorder |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 10/14/2017 |
| Start Date: | March 2004 |
| End Date: | August 2008 |
Supraphysiological Doses of Levothyroxine as Adjunctive Therapy in Bipolar Depression: A Multicenter, Randomized, Double-blind, Placebo-controlled Study.
There is growing evidence that thyroid axis dysfunction may contribute to the pathophysiology
of bipolar illness. Open-label studies have consistently demonstrated that the behavioral
expression of bipolar disorder can be modified by a change in thyroid status, and in many
instances the course of illness is improved through the use of adjunct thyroid hormone
treatment. Recent evidence emerged from acute intervention studies that add-on treatment with
supraphysiological doses of levothyroxine is an effective augmenting agent in patients with a
major depressive episode. The primary goal of this international multicenter trial (5 sites)
is to determine in a 13-week, randomized, placebo-controlled design (1 week single-blind
placebo run-in, 6 week double-blind, 6 week open-label) the efficacy and safety of add-on
treatment with levothyroxine (300 mcg/d) in combination with mood stabilizer/antidepressant
therapy in the treatment of patients with bipolar depression. The main hypotheses is:
treatment with levothyroxine will result in a significantly greater mean reduction of HRSD
total score and in a higher number of responders and remitters compared to placebo treatment.
This proposal will build on our pilot data and provide evidence for the use of levothyroxine
as an effective augmentation strategy in the treatment of bipolar depression.
of bipolar illness. Open-label studies have consistently demonstrated that the behavioral
expression of bipolar disorder can be modified by a change in thyroid status, and in many
instances the course of illness is improved through the use of adjunct thyroid hormone
treatment. Recent evidence emerged from acute intervention studies that add-on treatment with
supraphysiological doses of levothyroxine is an effective augmenting agent in patients with a
major depressive episode. The primary goal of this international multicenter trial (5 sites)
is to determine in a 13-week, randomized, placebo-controlled design (1 week single-blind
placebo run-in, 6 week double-blind, 6 week open-label) the efficacy and safety of add-on
treatment with levothyroxine (300 mcg/d) in combination with mood stabilizer/antidepressant
therapy in the treatment of patients with bipolar depression. The main hypotheses is:
treatment with levothyroxine will result in a significantly greater mean reduction of HRSD
total score and in a higher number of responders and remitters compared to placebo treatment.
This proposal will build on our pilot data and provide evidence for the use of levothyroxine
as an effective augmentation strategy in the treatment of bipolar depression.
Inclusion Criteria:
- Diagnosis of bipolar I or II disorder, currently depressive episode according to the
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)
- Hamilton Rating Scale for Depression (HAM-D) 17-item score ≥14, a HAM-D item 1
(depressed mood) score ≥2 at the screening and randomization visits
- Young Mania Rating Scale (YMRS) score ≤12 at the screening and randomization visits.
- Pretreatment with a mood stabilizer and/or an antidepressant at standard doses (Bauer
et al. 2007a) for at least six weeks since the last dose adjustment, and for at least
two weeks before enrollment
- Serum levels of mood stabilizer were required to be within therapeutic ranges
- TSH levels in normal range (serum TSH 0.3 - 4.7 mU/l)
Exclusion Criteria:
- Any axis I disorder other than bipolar disorder
- Recent ultra-rapid cycling course (12 or more episodes in previous year), - - a
diagnosis of substance dependence (DSM-IV) or substance use (except for nicotine)
within 12 months before the screening visit
- Clinically significant medical illness, especially severe cardiovascular diseases
- Organic brain disorder
- Current serious suicidal or homicidal risk by clinical judgment of the investigator
- History of previous or current thyroid disease
- Thyroid hormone treatment
We found this trial at
2
sites
1 Charitéplatz
Berlin, 10117
Berlin, 10117
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University of California at Los Angeles The University of California, Los Angeles (UCLA) is an...
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