Long term augmentation with T3 in refractory major depression

Background: The addition of triiiodothyronine (T-3) is one of the most widely studied augmentation strategies for refractory depression. Despite this there are no long term studies or studies of doses above 100 mcg. Method: Long term and high dose augmentation with T-3 for refractory unipolar major depression was studied. Seventeen patients were assessed for symptom improvement with the Clinical Global Impression of Improvement Scale. Results: Fourteen of 17 patients showed improvement. One patient saw no improvement and 2 dropped out due to side effects. The patients who benefited showed an average CGI improvement of 2.5 (SD: 0.52). The average dose used was 80 mcg (SD: 30.2, range: 25 mcg-150 mcg). The average length of time on T-3 was 24.2 months (SD: 19.4, range: 11.8-86.7). This case series shows that T-3 may be successfully employed as a long term treatment augmentation of major depression if over time dosage levels are increased beyond the traditional 50 mcg. (C) 2009 Published by Elsevier B.V.