An open study of triiodothyronine augmentation of tricyclic antidepressants in inpatients with refractory depression

Several studies, mainly performed in outpatients, suggest that triiodothyronine (T3) addition may convert depressed patients who are nonresponders to tricyclic antidepressants (TCAs) into responders. This study is to our knowledge the first study of T3 augmentation performed in severely depressed inpatients. In our study no evidence for the efficacy of adjunctive T3 treatment was found in a sample of 14 inpatients. T3 augmentation was performed over a four-week period; during the last three weeks the daily dosage was 37.5 μg. The patients involved were suffering from refactory depression and previously had not responded to an adequate six-week course of treatment with a TCA (mainly nortriptyline). Many of the patients were suffering from depression with melancholic and/or psychotic features. During follow-up, eleven of the patients responded to further treatment with either an MAOI or electroconvulsive therapy.