Less basal thyrotropin levels predict antidepressant response in patients with major depression

Abstract

Introduction The close association among thyroid metabolism, mood disorders and behavior has long been known. The role of basal thyroid axis in antidepressant treatment response is less known. Objectives The aim of the present study was to study the association of basal serum thyrotropin (TSH) levels, with antidepressant treatment response in major depressive disorder. Methods Thirty-one depressed adult outpatients were included. Major depressive episode was diagnosed through the MINI (DSM-IV-TR) interview. Clinical symptomatology and blood samples were assessed at baseline, and at 4- and 8-weeks of either escitalopram or sertraline. Treatment response was defined by an improvement ≥50% in MADRS scores at 4-, and 8-weeks. Basal TSH levels were included in a linear regression model as predictor of treatment response. Results Twenty-seven patients finished 8-weeks of treatment. Response to treatment was of 74% at 4-weeks, and 63% at 8-weeks of antidepressant treatment. Basal median TSH levels were between normal ranges (M+SD=1.85+1,02 mlU/L). Basal TSH levels not correlated with basal MADRS scores, but with higher MADRS scores at week-4 (r=0,415, p=0,031) and at week-8 (r=0,392, p=0,043). Moreover, less baseline TSH levels trend to be a significant good predictor for treatment response at 4-weeks (R2=.116, p=.083); and a good predictor at 8-weeks treatment (R2=.147, p=.049). Conclusions Baseline TSH levels even within the normal range may play a role in predicting antidepressant response. Disclosure No significant relationships.

Keywords

• tirotrophin
• major depression
• antidepressant response
• MADRS